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In a healthy individual these processes run quite smoothly In people with Hashimoto's the immune system produces
and the body keeps functioning properly. The thyroid antibodies, also called immunoglobulins, that attack the
regulates your metabolism and energy expenditure, thyroid gland. Antibodies are Y-shaped proteins that are a
influences body temperature regulation, heart rate, digestive normal part of the immune system as they attack pathogens
system and muscle function and has a profound effect on like viruses, bacteria and chemicals. In Hahismoto's disease,
fertility, the menstrual cycle and pregnancy. however, they attack the thyroid gland, more specifically two
things in the thyroid gland: an enzyme called Thyroid
Peroxidase (TPO) and a protein called Thyroglobulin (Tg).
These two antibodies are called anti-TPO andibodies and
anti-Tg antibodies. If either of the two are elevated, the
diagnosis is Hashimoto's.
What causes this insanity? There are many different causes but most often it is a combination of factors that contribute to the
development of autoimmunity. Those factors are infection, genetic predisposition, chemicals, stress, intestinal permeability,
food intolerances, radiation etc.
Most doctors will only order a TSH or a TSH + fT4 test. As explained in point , the most bioactive hormone is fT3 so it is of
utmost importance that fT3 gets tested. Why is fT3 not tested routinely? It is assumed that if a person has enough fT4 they will
consequently have enough fT3 as a result of the conversion process explained in point . However... A lot of people have a hard
time converting fT4 into fT3 due to different issues, one of them being a Deiodinase deficiency, the enzyme described in point
These people can not make enough fT3 on their own. Additionally, if both antibodies are not tested, you cannot know whether
or not you have Hashimoto's. There are other causes of hypothyroidism but remember, in 95% of the cases it is Hashimoto's.
Test results come with reference ranges and most doctors will consider everything to be "normal" if your
numbers fall within those ranges. Unfortunately those ranges are based on a bell curve and are very
wide. In reality, a healthy person's thyroid levels will be in a much more narrow range. Study link.
The ranges for fT3 and fT4 vary but are also too wide. In a
healthy individual fT3 will be in the upper half of the range
and fT4 in the upper 1/2 to 1/4 of the range.
Additionally, someone who has trouble converting fT4 to
fT3 will have lower fT3 levels with fT4 levels appearing
normal or high enough.
There are different types of thyroid medication available and it will depend on the person which one will suit them best.
Normally there is a period of trial and error when first starting thyroid medication but the most important thing is that the
dose is adjusted until optimal fT3 and fT4 levels are achieved.
The medication prescribed by default is called Levothyroxine. It comes under different names like Synthroid, Eltroxin, Euthyrox
etc. This is a T4-only medication and it may suit people who convert T4 to T3 well. Those who don't have other choices like
bovine or porcine Natural Desiccated Thyroid (NDT) that contains both T4 and T3. Unfortunately, NDT is often not subsidized
and the patient needs to pay for her/himself. There is also a T3-only medication available and some do best on that and then
there is a compounded T3+T4 option that some also have access to.
Another drug that can be taken by people with autoimmune thyroid disease is called Low-Dose Naltrexone or LDN. This is not a
hormone replacement medication but rather an immune system modulator that in many cases helps to bring antibodies down.