Autoimmune Hypothyroidism: Hashimoto’s Thyroiditis

Hashimoto’s disease — an autoimmune attack on the thyroid gland — is the most common cause of hypothyroidism in the United States. A simple blood test for thyroid peroxidase (TPO) antibodies can reveal whether your underactive thyroid is autoimmune in origin.

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The thyroid peroxidase (TPO) antibody test

Thyroid Peroxidase (TPO), an enzyme normally found in the thyroid gland, plays an important role in the production of thyroid hormones. A thyroid peroxidase test detects antibodies against TPO in the blood. The presence of thyroid peroxidase antibodies in your blood suggests that the cause of thyroid disease is due to an autoimmune disorder such as Hashimoto’s disease. In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue. Antibodies that attack the thyroid gland cause inflammation and impaired function of the thyroid.

What Hashimoto’s does

In Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, your immune system attacks your thyroid gland. The resulting inflammation often leads to an under active thyroid gland (hypothyroidism). Hashimoto’s disease is the most common cause of hypothyroidism in the United States. Hashimoto’s disease does not have unique signs and symptoms. The disease typically progresses slowly over a number of years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. The signs and symptoms are mainly those of an under active thyroid gland (hypothyroidism).

Signs and symptoms of hypothyroidism

The signs and symptoms of hypothyroidism vary widely, depending on the severity of hormone deficiency. At first, you may barely notice any symptoms, such as fatigue and sluggishness, or you may simply attribute them to getting older. But as the disease progresses, you may develop more obvious signs and symptoms.

Signs and symptoms of hypothyroidism include: fatigue and sluggishness; increased sensitivity to cold; constipation; pale, dry skin; a puffy face; hoarse voice; an elevated blood cholesterol level; unexplained weight gain; muscle aches, tenderness and stiffness, especially in your shoulders and hips; pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet; muscle weakness, especially in your lower extremities; excessive or prolonged menstrual bleeding (menorrhagia); and depression.

When hypothyroidism goes untreated

Without treatment, signs and symptoms gradually become more severe and your thyroid gland may become enlarged (goiter). In addition, you may become more forgetful, your thought processes may slow, or you may feel depressed.

Testing beyond TSH

Keep in mind that many nutrients such as zinc, copper, magnesium, selenium etc. all are important for healthy thyroid function. In addition to a TSH, free T4, free T3, reverse T3 and thyroid antibodies, a Micro Nutrient Test will identify what vitamins, minerals and other vital nutrients you are deficient in — then we can target those for replacement.

About the author

Allen Smolenski, M.D.

Emergency Medicine physician and founder of Coastal Medical Clinic in Surfside Beach (2009). After losing nearly 60 pounds himself — and placing third in his class at the 2008 NPC Natural Northern USA Bodybuilding Contest — he completed a fellowship in Anti-Aging and Regenerative Medicine through the A4M, and now helps patients across the Grand Strand optimize their hormones, metabolism, and long-term health.

Meet Dr. Smolenski →