Did you know 95% of hypothyroid patients also have Hashimoto’s?
I often get messages from readers who say that they have hypothyroidism but not Hashimoto’s. However, often they have BOTH.
What is the difference between hypothyroidism and Hashimoto’s?
Hypothyroidism, by definition, is a clinical state. It is a state of low levels of thyroid hormone in the body.
The low levels of thyroid hormone can occur as a result of a variety of different reasons, such as iodine deficiency, surgical removal of the thyroid, excess use of thyroid suppressing medications, pituitary suppression, or damage to the thyroid (physical or disease induced).
Most cases of hypothyroidism in the United States, Canada, Europe, and in most countries that add iodine to their salt supply are caused by Hashimoto’s, an autoimmune condition. Depending on the source, estimates are that between 90-97% of those with hypothyroidism in the United States have Hashimoto’s.
Have you been diagnosed with hypothyroidism?
Unfortunately, many people think that if they had Hashimoto’s, their doctors would have certainly told them.
But that’s not usually the case. Many doctors simply don’t test their patients for Hashimoto’s. That’s because the conventional medical model treats autoimmune thyroid disorders in the same way as they would treat someone with a nutrient deficiency induced thyroid disorder, a congenital defect of the thyroid gland, someone who was born without a thyroid, or someone who had their thyroid removed or treated with radioactive iodine… with synthetic thyroid hormones.
I found a useful tool called Google Trends that allows you to looks at the search trends in Google searches for various topics.
Below you will find a chart showing searches in RED for HYPOTHYROIDISM and searches in BLUE for HASHIMOTO’S. As you can see the number of searches for HYPOTHYROIDISM clearly surpasses those for HASHIMOTO’S.
These trends lead me to wonder if the people searching for hypothyroidism have ever been tested for Hashimoto’s…
After being diagnosed with hypothyroidism, many people are told that their “thyroid is sluggish” and that these things happen with age and often hear: “Just take this pill, you’ll be fine…”
But they’re not told that they have an autoimmune condition.
Thus, they never think to ask the question: “Why is my immune system attacking my thyroid?” Therefore, they never know to address the immune system imbalance and never get an opportunity to prevent or reverse the progression of the disease.
If you’ve been diagnosed with hypothyroidism, you should also be tested for Hashimoto’s.
Often, a person will be diagnosed with Hashimoto’s after already being diagnosed with hypothyroidism. Therefore, she will have both Hashimoto’s and hypothyroidism.
But it’s also possible to have Hashimoto’s and not yet have hypothyroidism.
Other times I’ll get messages from readers with lots of Hashimoto’s related symptoms who say they’ve repeatedly been tested for thyroid issues, but all of their tests have come out “fine.” That’s because they have never been given the specific tests for Hashimoto’s.
Studies have found that thyroid antibodies indicative of Hashimoto’s can be present for as long as a decade before the person develops impaired thyroid function. I suspect that they can be elevated for much longer, and it may take a person many decades to learn that he/she has hypothyroidism due to inadequate use of the TSH screening test.
Elevated thyroid antibodies have been connected with feelings of distress, anxiety, and depression in those with Hashimoto’s.
Also, the higher the antibodies, the more likely you are to experience symptoms of hyperthyroidism (when the thyroid cells are broken down, and stored hormone is dumped into the bloodstream), as well as hypothyroidism (when we don’t have enough thyroid hormone). Your TSH screening tests may still fall into the “normal range.” Thus, in the early stages of Hashimoto’s, the person may still be able to make enough thyroid hormone and will have “normal” thyroid function.
The higher the thyroid antibodies, the higher your likelihood of developing overt hypothyroidism and possibly additional autoimmune conditions.
Make sure to read here if you swing back and forth from hypothyroidism to hyperthyroidism.
You can read more about the TSH test in my post: What to do when your TSH is normal, and you are anything but…
The autoimmune attack on the thyroid develops decades before a person becomes hypothyroid. Catching the condition early allows us to prevent progression and needless suffering. The person may suffer from symptoms of Hashimoto’s for years before they are finally diagnosed with hypothyroidism and placed on medications.
Recently two women in my family were diagnosed with Hashimoto’s. I love and admire them both very much. Both are in their sixties and struggled with symptoms like anxiety, fatigue, cold intolerance, weight fluctuations, and brain fog for many decades.
They are both very highly educated women (one has a doctorate, the other has a masters) and have been very health conscious as far back as I can remember, going to fitness classes, eating organic foods, and lecturing me on my liberal use of sugar in my younger days 🙂
Both of them have also been tested for thyroid problems by their doctors—repeatedly—and told that their thyroid function was “normal.” This is because their doctors did not run the correct tests, just an outdated “screening test.”
Both women requested the correct tests at my insistence, and sure enough, they both have Hashimoto’s. I’m glad that we finally have an answer to their mysterious symptoms, and we can now get them on the right path to healing so that we can prevent the progression of their conditions.
I am a proponent of not just using medications for hypothyroidism caused by Hashimoto’s but also of rebalancing the immune system to prevent further attack on the thyroid. You can read more in my post on various opportunities for interventions for Hashimoto’s and hypothyroidism.
Ideally, a person would get diagnosed with Hashimoto’s before she is diagnosed with hypothyroidism. That way she would know that she is at risk for hypothyroidism and would have an opportunity to identify the underlying reasons for her immune system’s attack on the thyroid.
So how do you diagnose Hashimoto’s?
Thyroid ultrasounds, as well as blood tests, are used to diagnose Hashimoto’s. (Looking for a practitioner who follows the root cause approach? Click here for my free list of contacts!)
In most cases of Hashimoto’s thyroiditis, blood tests will reveal one or two types of anti-thyroid antibodies.
Thyroid peroxidase antibody (TPOAb) is the most common antibody present (in up to 95% of those with Hashimoto’s), and often antibodies against thyroglobulin (TGAb) are found as well (around 80%).
These antibodies may appear decades before a change in TSH is detected, thus allowing people to make an intervention before the thyroid gland gets damaged to a point where it will no longer be able to make enough thyroid hormone. While it’s possible to regenerate thyroid tissue, and some people can come off medications, (some do it faster than others, and I’m currently studying ways to accelerate thyroid tissue regeneration), it’s much easier to prevent the destruction of thyroid tissue than to regenerate it. An ounce of prevention is worth a pound of cure.
Thus, thyroid antibody screening is always crucial in suspected thyroid disease.
At-risk populations: Hashimoto’s runs in families and is 5-8 times more common in women. Therefore I would urge all of you with Hashimoto’s and/or hypothyroidism to encourage your daughters, sisters, mothers, aunts, and grandmothers to get tested, especially if they are in the age range of puberty, pregnancy, and perimenopause—the three most common times for thyroid hormone abnormalities to surface. Also, just because the condition is more common in women does not mean that men are not affected. I would urge you to have your male family members tested as well.
Top 6 Thyroid Tests
Here is a comprehensive list of the top 6 thyroid tests take to your doctor and can ask for tests for Hashimoto’s and hypothyroidism. Be sure to request a copy of your thyroid labs so that you can see them yourself and ensure that they are interpreted correctly.
- TSH (Thyroid Stimulating Hormone)
- Thyroid peroxidase antibodies (TPO Antibodies)
- Thyroglobulin Antibodies (TG Antibodies)
- Thyroid Ultrasound
- Free T3
- Free T4
TSH – This is a pituitary hormone that responds to low/high amounts of circulating thyroid hormone. In advanced cases of Hashimoto’s and primary hypothyroidism, this lab test will be elevated, (read the post about interpreting the TSH test). In the case of Graves’ disease, the TSH will be low. People with Hashimoto’s and central hypothyroidism may have a normal reading on this test.
Thyroid peroxidase antibodies (TPO Antibodies) and Thyroglobulin Antibodies (TG Antibodies) – Most people with Hashimoto’s will have an elevation of one or both of these antibodies. These antibodies are often elevated for decades before a change in TSH is seen. People with Graves’ disease and thyroid cancer may also have an elevation in thyroid antibodies including TPO & TG, as well as TSH receptor antibodies.
Thyroid Ultrasound – A small percentage of people may have Hashimoto’s, but may not have thyroid antibodies detectable in the blood. Doing a thyroid ultrasound will help your physician determine a diagnosis.
Free T3 & Free T4 – These tests measure the levels of active thyroid hormone circulating in the body. When these levels are low, but your TSH tests in the normal range, this may lead your physician to suspect a rare type of hypothyroidism, known as central hypothyroidism.
If your doctor will not order these tests for you, you can pay out of pocket and order them yourself thought a company like Ulta Lab Tests.
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