Hashimoto Thyroiditis is an autoimmune process where your immune system will attack your thyroid gland. This attack will eventually cause the thyroid function to drop. Inevitably, Hashimoto’s disease causes hypothyroid.
There are two primary blood antibodies to test for Hashimoto’s disease.
- Thyroid Peroxidase Antibody (TPO)
- Thyroglobulin Antibody (TgAb).
If you have one or both of these antibodies, then you would be positive for Hashimoto’s disease.
Some people have these antibodies and do not have any hypothyroid issues or changes to their TSH, Free T4, and Free T3. If you catch the presence of the antibodies early enough, you can prevent the onset of Hashimoto’s or the severity of it through supplementation, diet, and lifestyle. As stated above, Hashimoto’s is an autoimmune condition, leading to hypothyroid. Several factors can cause, exacerbate or reduce the onset of Hashimoto’s thyroiditis. Females are more likely to have Hashimoto’s disease Hashimoto’s and it runs in families.
High levels of chronic stress can cause a rise in cortisol. Chronic elevations of cortisol can alter immune function.
Ingesting a highly processed, refined carbohydrate diet can cause higher levels of insulin and cortisol which again, can alter immune function. Many people have gluten intolerance, and that can exacerbate the onset and severity of Hashimoto’s.
A thyroid ultrasound is a non-invasive way of imaging the thyroid. People with Hashimoto’s can have enlarged thyroids, multiple nodules or cysts on the thyroid. But many people without thyroid disease or Hashimoto’s can have nodules and thyroid anomalies. So an ultrasound is not a definitive way of finding out if you have Hashimoto’s.
If you are wondering if you have Hashimoto’s thyroiditis, have your blood tested for the presence of Thyroid Peroxidase Antibody (TPO) and Thyroglobulin Antibody (TgAb).
The presence of Thyroid Peroxidase Antibodies is the most common in Hashimoto’s Disease. About 70-80% of people with Hashimoto’s with have the TPO antibodies present. Most doctors only test the Anti-TPO in patients, but it is important to also check for the Thyroglobulin Antibodies so that they are not missing patients with Hashimoto’s Disease.
In about 15-20% of patients with Hashimoto’s disease, the Thyroglobulin antibodies only are present. The presence of TPO and TG antibodies together is much less common at about 5%.
TPO <9 iu/mL
TGab <1 iu/mL
Monitoring the presence and the levels of Hashimoto’s Antibodies is essential in treatment. While Hashimoto’s does lead to hypothyroidism, It is important not to just focus on the hypothyroid aspect of Hashimoto’s disease. While keeping the thyroid function levels in optimal range is a good start in Hashimoto’s. It is also key to work on the adrenals, hormones and immune system. Monitoring the levels of TPO and TgAb can help in evaluating treatment with a patient that has Hashimoto’s.
If you are unsure if you have Hashimoto’s disease, the best way to find out is to do a blood test. Testing for Thyroid Peroxidase (TPO) and Thyroglobulin Antibody (TgAb) will show you if you have or have the potential for Hashimoto’s thyroiditis. Hashimoto’s Disease not only can cause hypothyroid, but it can also cause other conditions in the body.
Hashimoto’s can cause or exacerbate:
- Joint pain
- High cholesterol
- Anemia/low iron
- Weight gain
- Brain fog/forgetful/unfocused
- More susceptible to viruses
- Dry skin
- Hair loss
- Mood issues
- Heart Palpitations
- Sleep disturbances
- Disruptions in menstrual cycle
After you have had the Thyroid Peroxidase Antibody (TPO) and Thyroglobulin Antibody (TgAb) tested, and you have shown positive in one or both. It would be a good idea to get a more thorough blood test for the effects that Hashimoto’s can have. These blood tests are:
Basic thyroid function and Hashimoto’s testing: TSH, FreeT4, FreeT3, Thyroid Peroxidase Antibody and Thyroglobulin Antibody.
Additional Lab Tests
- Lipid panel
- Insulin, fasting
- Sed Rate
- TSI: thyroid stimulating immunoglobulin to rule out Grave’s Disease
There are other tests that can also be done such as Epstein Barr Virus, other autoimmune and genetic testing. I like to start here so that we can set up a treatment plan to get the patient feeling better. The patient needs to feel better before they can explore exercise, eat better, or work on lifestyle measures. Once a patient is feeling better then we can move on from there in treatment and other causes for Hashimoto’s Disease.
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