Definition:

Thyroiditis is an inflammatory condition of the thyroid gland.  Hashimoto’s Thyroiditis is an autoimmune form of thyroiditis, when lymphocytes gradually destroy thyroid tissue.  In the early inflammatory stages of the disorder patients may present with hyperthyroidism, but as the disease progresses, the damaged thyroid tissue is unable to produce sufficient thyroid hormone and hypothyroidism develops.  Hashimoto’s Thyroiditis is the most common cause of clinical hypothyroidism in Australia.

Aetiology / Risk Factors

Major risk factors associated with the incidence of Hashimoto’s Thyroiditis include:

• Positive family history of autoimmunity
• Personal history of autoimmunity
• Pregnancy
• Hyperoestrogenaemia – excess oestrogen can decrease thyroid activity through increasing amounts of de-iodinase enzymes and increasing the number of pituitary T3 receptors, which inhibits TSH release.

Dietary and lifestyle:

• The thyroid gland is very susceptible to toxicity, especially heavy metals. Reduce exposure to heavy metal toxicity, plus endogenous and exogenous antigenic material, by following the an detoxification program.
• Investigate dietary triggers to immune responses with the elimination and rechallenge diet.
• Avoid foods that suppress thyroid function – e.g., broccoli, cabbage, brussel sprouts, cauliflower, kale, spinach, turnips, soy, beans, and mustard greens.  These vegetables contain isothiocyanates, which may block iodine utilisation.
• Follow the principals of a wellness lifestyle program to consume an anti-inflammatory, low glycaemic load diet incorporating stress management, exercise and micronutrient supplementation

Lifestyle Management plan:

• Exercise is very important in the treatment of hypothyroidism. Exercise stimulates thyroid gland secretion and increases sensitivity to thyroid hormone. Start by walking or swimming everyday. Yoga, palettes and light aerobic work is a great way to start, the key is getting active. It may seem hard at first but your body and mind will love you once you start.
• Reflexology is beneficial for hypothyroidism.
• Buy a water filter. Some waters are chlorinated and have fluorine added, which can blocks iodine receptors in the thyroid gland.
• Eat small regular healthy meals.
• Good food is fantastic in helping you increase your energy.

Diet:

• Seaweed, such as nori and dulse are powerful healing foods for hypothyroidism due to iodine deficiency. They are the best dietary source of iodine.
• Eat deep-sea fish and seafood such as clams, lobster and oysters from clean, uncontaminated waters, regularly. They provide iodine plus vitamin A and zinc, which are needed for thyroid hormone production.
• Reduce the exposure to goitrogens and thiocyanates i.e. reduce the intake of brassicas, cabbage, cauliflower, Brussels sprouts and cyanate foods, apples, walnuts and almonds.
• Increase omega 3 and 6 polyunsaturated oil.
• Decrease saturated and trans fats.
• With hypothyroidism, the conversion of beta-carotenes from vegetables and fruits into vitamin A is disturbed. Since vitamin A is necessary for thyroid hormone production, it is important to eat foods, which contain pre-formed vitamin A, such as eggs, whole unhomogenized milk and whole milk daily products like full fat, raw milk cheeses and plain natural yoghurt.
• Eggs and milk also provide zinc and vitamin E, both which are needed for thyroid hormone production.
• Raw wheat germ and raw, unroasted pumpkin seeds added to morning muesli of rolled oats are other good food sources of vitamin E and zinc.
• Beet leaves, parsley, carrots and watercress juice are high in calcium, which is needed for an under active thyroid and help avoid goiters.
• Avoid coffee.
• Do not drink tea, which contains fluorine, or fluorinated or chlorinated drinking water because it blocks iodine receptors in the thyroid gland.
• Avoid foods, which inhibit iodine utilisation, including turnip, cabbage, mustard, cassava root, soybeans, peanuts, pine nuts and millet.

Pathology Tests:

Thyroid antibody test – High titres of Thyroid Microsomal Antibodies are indicative of Hashimoto’s Thyroiditis.

Thyroid function tests (TFT) – Thyroid hormones regulate metabolism and the production of sex hormones. A deficiency of free T4 and/or elevated TSH may indicate hypothyroidism.

Normal Values

TSH: 0.4 – 4.0mIU/L

Free T3: 4.0-8.0pmol/L

Free T4: 10-25pmol/L

Subclinical hypothyroidism TSH: 2.5 – 4.0mlIU/L