What Causes Hashimoto’s Thyroiditis And How To Manage It
Exactly what causes Hashimoto’s thyroiditis is unknown, although genetics, the microbiome, and environmental factors are all responsible, as is the case with many autoimmune disorders. Hashimoto’s thyroiditis results in the body’s immune system mistakenly attacking and damaging healthy cells in the thyroid gland, leading to inflammation.1
Hashimoto’s Thyroiditis – T And B Cells Inflammatory Infiltration
The infiltration of T and B cells into the thyroid is one of the hallmarks of Hashimoto’s thyroiditis and contributes to the development of this disorder. This leads to inflammation and destruction of thyroid tissue, which affects the production of hormones.
T cells are a type of white blood cell that plays a vital role in immunity by responding to foreign substances such as bacteria, viruses, and toxins. They help activate other immune system components, including B cells, which produce antibodies to fight infection. In Hashimoto’s thyroiditis, T cells recognize the thyroid tissue as an invader and mount an attack, leading to inflammation.
B cells are a type of white blood cell that also play a role in immunity. They produce antibodies, which help fight foreign invaders like bacteria and viruses. In Hashimoto’s thyroiditis, B cells are thought to cause inflammation by producing antibodies that attack the thyroid tissue.2
What Causes Hashimoto’s Thyroiditis – Antibodies Against Thyroid Antigens
Hashimoto’s thyroiditis is diagnosed through laboratory tests that measure the levels of specific antibodies in the blood. The two most common antibodies seen in cases of Hashimoto’s are anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg). An increase in either or both of these antibodies is an indication that Hashimoto’s is present.2
In addition, imaging tests such as ultrasound or nuclear medicine scans can be used to detect any changes in the thyroid gland. Finally, a biopsy of the thyroid may be performed to collect more information about the thyroid tissue and its functioning. This is most common if there is a suspicion of cancer or other diseases that affect the thyroid gland.3
In any case, most people suffer from Hashimoto’s years before laboratory tests are able to provide the feedback required to diagnose it.
Hashimoto’s Thyroiditis And Thyroid Cancer
In some cases, Hashimoto’s Thyroiditis can also lead to an increased risk of developing thyroid cancer. Studies have linked the condition to a higher risk of papillary and follicular thyroid cancer, two common types of thyroid cancer. The risk is still low overall but increases over time as inflammation continues.
Fortunately, treatment for Hashimoto’s Thyroiditis can help to reduce the risk of developing thyroid cancer. Maintaining a healthy lifestyle with regular exercise and a balanced diet can help to reduce the risk of developing thyroid cancer.4
What Is Hashimoto’s Encephalopathy?
Hashimoto’s encephalopathy, also referred to as Hashimoto–Pritzker syndrome or steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a rare neurological disorder that is associated with autoantibodies against the thyroid gland. It most commonly occurs in patients with Hashimoto’s thyroiditis. Symptoms of Hashimoto’s encephalopathy can range from mild confusion and memory loss to seizures, abnormal movements, coma, and even death in rare cases.
Treatment for the condition typically involves steroid medications to reduce inflammation and suppress the immune system. Patients are also encouraged to avoid known triggers of their condition. In some cases, intravenous immunoglobulin therapy or plasma exchange may be utilized in order to reduce the levels of autoantibodies in the patient’s blood.5
The Similarities Between Hashimoto’s Thyroiditis And Graves’ Disease
Both Hashimoto’s thyroiditis and Graves’ disease are autoimmune disorders of the thyroid gland. They both cause the immune system to mistakenly attack and damage healthy thyroid tissue, leading to overproduction or underproduction of hormones.
The two conditions have similar symptoms including fatigue, weight gain or loss, heat/cold intolerance, depression, muscle aches and pains, dry skin and hair, goiter or swelling of the neck, irregular menstrual cycles in women, an enlarged thyroid gland, anxiety, and nervousness.
While Hashimoto’s thyroiditis is more likely to cause hypothyroidism meaning low levels of hormones, Graves’ disease is more likely to cause hyperthyroidism signifying high levels of hormones.
Both Hashimoto’s thyroiditis and Graves’ disease can lead to long-term complications, such as a weakened immune system, an increased risk for cardiovascular diseases, osteoporosis, and infertility.6
What Causes Hashimoto’s Thyroiditis – Genetics
182 differentially expressed genes have been shown to contribute to Hashimoto’s Thyroiditis. These genes are involved in a variety of pathways, mainly sensory perception associated with the olfactory system.7
What Causes Hashimoto’s Thyroiditis – Environmental Factors
Environmental factors also contribute to the development of Hashimoto’s thyroiditis. Exposure to certain toxins and pollutants, such as heavy metals, can damage the thyroid gland and potentially trigger an autoimmune response. Studies have also linked a diet low in iodine with an increased risk for Hashimoto’s thyroiditis.
Stress, alcohol consumption, and smoking can also increase the risk of developing this condition. It is possible that these environmental factors work together to trigger an autoimmune response in the body which ultimately leads to Hashimoto’s thyroiditis.
What Causes Hashimoto’s Thyroiditis – Low Levels Of Dietary Iodine
Iodine is an essential nutrient and is necessary for the production of thyroid hormones. Low levels of dietary iodine can lead to Hashimoto’s thyroiditis. The most common cause of low iodine levels is not getting enough in the diet, but it could also be a result of other health conditions like kidney disease or autoimmune disorders. Some medications, such as lithium, can also interfere with iodine absorption.8
What Causes Hashimoto’s Thyroiditis – Low Levels Of Dietary Selenium
One of the most important causes of Hashimoto’s thyroiditis is a selenium deficiency. Selenium is a trace mineral that plays an essential role in thyroid health and metabolism. Research has shown that low levels of dietary selenium are linked to an increased risk of developing autoimmune conditions, including Hashimoto’s thyroiditis.
Selenium helps to protect the thyroid gland from damage caused by oxidative stress. It is also involved in the production of certain hormones, such as triiodothyronine (T3) and thyroxine (T4). Low levels of dietary selenium can lead to an imbalance in hormone production, which can contribute to Hashimoto’s thyroiditis.9
Hashimoto’s Thyroiditis And Low Levels Of Vitamin D
Vitamin D plays an important role in the management of Hashimoto’s thyroiditis, as Vitamin D deficiency is linked to an increased risk and severity of the autoimmune condition. It has been observed that individuals with low levels of vitamin D are more likely to develop Hashimoto’s disease than those with sufficient levels. Furthermore, a study found that supplementing with vitamin D3 can help reduce the symptoms of Hashimoto’s thyroiditis.10
Read more about how low Vitamin D levels are linked to many autoimmune conditions.
Hashimoto’s Thyroiditis And Low Levels Of Vitamin B12
Vitamin B12 is another important vitamin for thyroid health. Low levels of B12 can cause fatigue and other symptoms associated with Hashimoto’s. The best sources of this vitamin include animal products like meat, fish, and eggs. It can also be taken in supplement form to help improve thyroid functioning.11
What Causes Hashimoto’s Thyroiditis – Iron
Iron deficiency anemia has been associated with Hashimoto’s thyroiditis. Iron is necessary for the production of thyroid hormones. Iron-rich food can help improve thyroid function in people with Hashimoto’s if they are iron deficient. Foods such as beans, spinach, and red meats are good sources of dietary iron.12
What Causes Hashimoto’s Thyroiditis – Gut Microbiotica
Studies have concluded that there is a connection between the composition of microorganisms within the gut and Hashimoto’s Thyroiditis development. Some theories suggest that an imbalance in the gut microbiome could lead to inflammation and autoimmunity, which can cause Hashimoto’s Thyroiditis. Additionally, research has indicated that gut bacteria could influence the metabolism of thyroid hormones, potentially increasing the risk for Hashimoto’s Thyroiditis.
There are several potential mechanisms by which gut microbiota may contribute to Hashimoto’s Thyroiditis development. One theory suggests that an imbalance in the composition of gut bacteria or a leaky gut, defined as increased intestinal permeability, could allow toxins produced by gut bacteria to enter the bloodstream, triggering an autoimmune response and leading to Hashimoto’s Thyroiditis.
Another possible mechanism is that certain gut bacteria may affect the metabolism of thyroid hormones, leading to altered levels of active thyroid hormone in the body and triggering Hashimoto’s Thyroiditis. In addition, researchers have suggested that some bacterial species may activate proinflammatory pathways, resulting in inflammation that can lead to autoimmune responses and Hashimoto’s Thyroiditis.13
Managing Hashimoto’s Thyroiditis
Management of Hashimoto’s Thyroiditis typically involves lifelong maintenance of thyroid hormone levels with replacement therapy. Patients are monitored via regular laboratory tests to ensure the levels remain stable and in an optimal range.
In addition, lifestyle changes such as stress reduction, a healthy diet, supplementation, and adequate exercise can help to manage the disease.
Managing Hashimoto’s – Nigella Sativa
Nigella sativa, a flowering plant common in the Middle East and South Asia, commonly known as black cumin, is gaining attention among researchers for its potential use in managing Hashimoto’s thyroiditis. Studies have shown that certain Nigella sativa components may help reduce levels of TSH, improve thyroid function, and stabilize autoantibodies associated with the autoimmune disorder.
Nigella sativa is high in antioxidants and compounds that possess anti-inflammatory properties, which are believed to reduce inflammation associated with Hashimoto’s. One study showed that supplementing with Nigella sativa could help to reduce TSH levels. Other studies have demonstrated that supplementation with Nigella sativa could improve thyroid function and reduce autoantibody levels.14
What Causes Hashimoto’s Thyroiditis – And How To Manage It
Now that you know what causes Hashimoto’s thyroiditis and how to manage the disease, focus on improving lifestyle choices that include a healthy diet rich in vitamins and minerals necessary for the optimal function of the thyroid.
1 American Thyroid Association. (2020b, June 8). Hashimoto’s Thyroiditis | American Thyroid Association. https://www.thyroid.org/hashimotos-thyroiditis/
2 Ralli M, Angeletti D, Fiore M, D’Aguanno V, Lambiase A, Artico M, de Vincentiis M, Greco A. Hashimoto’s thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev. 2020 Oct;19(10):102649. doi: 10.1016/j.autrev.2020.102649. Epub 2020 Aug 15. PMID: 32805423.
3 Quintero, B. M. (2021). Thyroiditis: Evaluation and Treatment. AAFP. https://www.aafp.org/pubs/afp/issues/2021/1200/p609.html
4 Feldt-Rasmussen U. Hashimoto’s thyroiditis as a risk factor for thyroid cancer. Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):364-371. doi: 10.1097/MED.0000000000000570. PMID: 32773575.
5 Churilov LP, Sobolevskaia PA, Stroev YI. Thyroid gland and brain: Enigma of Hashimoto’s encephalopathy. Best Pract Res Clin Endocrinol Metab. 2019 Dec;33(6):101364. doi: 10.1016/j.beem.2019.101364. Epub 2019 Nov 23. PMID: 31801687.
6 Paknys G, Kondrotas AJ, Kevelaitis E. Hasimoto tiroidito rizikos veiksniai ir patogeneze [Risk factors and pathogenesis of Hashimoto’s thyroiditis]. Medicina (Kaunas). 2009;45(7):574-83. Lithuanian. PMID: 19667753.
7 Qiu K, Li K, Zeng T, Liao Y, Min J, Zhang N, Peng M, Kong W, Chen LL. Integrative Analyses of Genes Associated with Hashimoto’s Thyroiditis. J Immunol Res. 2021 Aug 28;2021:8263829. doi: 10.1155/2021/8263829. PMID: 34493981; PMCID: PMC8418929.
8 Liontiris MI, Mazokopakis EE. A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients.Points that need more investigation. Hell J Nucl Med. 2017 Jan-Apr;20(1):51-56. doi: 10.1967/s002449910507. Epub 2017 Mar 20. PMID: 28315909.
9 Guastamacchia E, Giagulli VA, Licchelli B, Triggiani V. Selenium and Iodine in Autoimmune Thyroiditis. Endocr Metab Immune Disord Drug Targets. 2015;15(4):288-92. doi: 10.2174/1871530315666150619094242. PMID: 26088475.
10 Jamka M, Ruchała M, Walkowiak J. Witamina D a choroba Hashimoto [Vitamin D and Hashimoto’s disease]. Pol Merkur Lekarski. 2019 Sep 25;47(279):111-113. Polish. PMID: 31557141.
11 Dahiya V, Vasudeva N, Sharma S, Kumar A. Role of Dietary Supplements in Thyroid Diseases. Endocr Metab Immune Disord Drug Targets. 2022;22(10):985-996. doi: 10.2174/1871530322666220419125131. PMID: 35440339.
12 Hu S, Rayman MP. Multiple Nutritional Factors and the Risk of Hashimoto’s Thyroiditis. Thyroid. 2017 May;27(5):597-610. doi: 10.1089/thy.2016.0635. Epub 2017 Apr 6. PMID: 28290237.
13 Mori K, Nakagawa Y, Ozaki H. Does the gut microbiota trigger Hashimoto’s thyroiditis? Discov Med. 2012 Nov;14(78):321-6. PMID: 23200063.
14 Farhangi MA, Dehghan P, Tajmiri S, Abbasi MM. The effects of Nigella sativa on thyroid function, serum Vascular Endothelial Growth Factor (VEGF) – 1, Nesfatin-1 and anthropometric features in patients with Hashimoto’s thyroiditis: a randomized controlled trial. BMC Complement Altern Med. 2016 Nov 16;16(1):471. doi: 10.1186/s12906-016-1432-2. PMID: 27852303; PMCID: PMC5112739.