The thyroid and autoimmune disease is a topic which can be confusing if you do not understand the differences between hypothyroidism and hyperthyroidism. Thyroid problems are much more common than people realize.
The thyroid is linked to two types of autoimmune diseases in the body. This article describes the common signs and symptoms that indicate a thyroid with a problem and potential causes and solutions.
What is the Thyroid?
The thyroid gland is a small flat butterfly shaped gland residing in front of the throat. It is responsible for metabolism and it acts as a thermostat in the body turning the heat up and down in the over 40 trillion cells each of which has thyroid hormone receptors.
This means the thermostat of the thyroid determines the activity level of every cell in the body, so if the thyroid slows down everything in your body slows down.
Diagnosis of thyroid problems is done by measuring the level of the is thyroid-stimulating hormone (TSH) in the body. This is measured within a range from 0.5 to 5.0 with anything in between that being normal even though the high number is 10 times higher than the low. If it is over 5.0 then a condition of hypothyroidism is diagnosed and usually, hormone replacement therapy is recommended.
There are other sub classifications within the range of 0.5 to 5.0. An optimal range is between 1.8 and 3.5 with a median normal value of 2.5. Between 3.0 and 5.0 is not fully hypothyroid but functionally hypothyroid because of a reduced function.
At the other end of the spectrum, one expects a condition of functional hyperthyroidism, BUT IT IS NOT. Rather, it is also functional hypothyroid but for different mechanisms.
It is very common, and this is because the pituitary which makes thyroid-stimulating hormone is under performing so it is just not sending out enough TSH resulting in functional hypothyroidism. This happens very often with insulin resistance.
Is The Thyroid And Autoimmune Disease Common?
The condition of over activity of hyperthyroid is rare. It is only about 1%, while hypothyroid is about 10 to 50% of the population. Hypothyroidism where the thyroid is under performing commonly occurs because of iodine deficiency.
About 800 million people in the world live where the soil does not have a lot of iodine and about 25% of those people have an under performing thyroid.
A study in Germany found that 33% of a population of 96,000 people ranging between 18 to 65 years had abnormal thyroids. This was found to increase dramatically with adults over 50 years.
Autoimmune diseases affect women more frequently than men, and can occur at any age. Autoimmune thyroid disease is relatively common. Anti-thyroid antibodies are present in up to 20% of the U.S. population.
Autoimmune thyroiditis occurs when thyroid cells are damaged by the immune system. It is probably due to a combination of environmental and genetic factors (American Thyroid Association 2007)
Causes of Hypo- and Hyper- Thyroids?
The most common cause of hypothyroidism is iodine deficiency. For people that do not live in an area where there is low iodine and who are diagnosed with hypothyroidism, then the most common cause is something called Hashimoto’s disease.
Very few people with Hashimoto know that they have it (until diagnosed) because it is an autoimmune disease.
The major cause of hyperthyroidism is another autoimmune disease called Graves’ disease
Intrusive Symptoms of A Thyroid Problem
Hypothyroid – Sensitive to cold. These people always feel cold, wear sweaters and always want extra blankets. They do not like air conditioning and always want to be out in the sunshine or near a heater in colder weather.
Hyperthyroid – Opposite. These are people sensitive to heat, so they always want the air conditioner on or a fan blowing.
For either of these conditions, dual season washable weighted blankets may be helpful.
Hypothyroid – Experience more weight gain despite having a lowered appetite. Metabolism slows down.
Hyperthyroid – Experience weight loss despite having a voracious appetite. In this case, metabolism is very high.
Hypothyroid – Constipation because everything slows down
Hyperthyroid – Frequent bowel movement and diarrhea because everything speeds
Hypothyroid – Often experience chronic fatigue simply because insufficient energy is being created.
Hyperthyroid – In this condition, although a lot of energy is made, it is being used up for the wrong functions. This energy is being used to create heat, causing the tissues to burn through energy faster leaving little energy for regular body activities. While these people are often fatigued, they find it difficult to sleep because of this constantly racing over activity of the cells.
Hypothyroid – Because the thyroid is under performing, there is usually depression, poor focus and memory problems because not enough energy is being created to support these functions.
Hyperthyroid – There is agitation and anxiety, although a lot of energy is being created. Poor focusing abilities remain, and, the individual may demonstrate resting vibration tremors.
Less Intrusive But Visible Symptoms of The Thyroid And Autoimmune Disease
Changes in the heart rate:
Hypothyroid – People with this condition experience a slower heart rate called bradycardia. This can fall as low as between 50-60 beats in someone who is not exercising and in good shape.
Hyperthyroid – In this condition there is a very fast heart rate called tachycardia. This can increase up to 100 – 120 beats or even higher.
Hypothyroid – Because of iodine deficiency, the thyroid grows just so it has more tissue to increase its absorption capacity for iodine, in an attempt to compensate for a lack of it. The thyroid tissue in this condition is just healthy, and there is nothing wrong with it. It however looks unseemly and frightening with its grapefruit-size enlargement. This type of goiter is benign goiter meaning that it has non-pathological tissue
Hyperthyroid – While there may also be a slight enlargement, this condition is due to tumors and nodules in the thyroid. We do not see a huge bulge.
Hair texture changes:
Hypothyroid – Coarse hair with hair loss
Hyperthyroid – Fine brittle hair still accompanied by hair loss.
Changes in the skin:
Hypothyroid – Rough coarse dry skin
Hyperthyroid – Thin paper-like skin
The eyes and changes:
Hypothyroid – Swollen puffy eyes.
Hyperthyroid – Bulging eyes caused by the swelling of tissue behind the eyes making the eyes protrude.
Treatment of Hypothyroidism
The treatment of hypothyroidism is usually with iodine or hormone replacement either with synthetic or more natural medication. Some potential problems could arise from this treatment. Giving iodine to someone deficient is not a problem as they will simply return to normal.
However, administering iodine to someone who has an autoimmune attack on their thyroid that is already creating compensatory activity by growing larger will only allow the autoimmunity to progress. In essence, the symptom is being targeted while the root cause – the autoimmune disease is not being addressed.
Because the thyroid is a very sensitive tissue, it is usually the first tissue in the body to get come under an autoimmune attack but if it is not addressed early enough, the attack can spread to other tissues and cells in the body such as the gut, joints, pancreas, cerebellum of the brain and the skin. The problem worsens!
Treatment of Hyperthyroidism
To suppress the over activity of the thyroid, hyperthyroidism is typically treated with anti thyroid medication .
Another method is using radioactive iodine. Because the thyroid absorbs iodine more selectively than any other tissue in the body, radioactive iodine can be laced with carrier molecules to destroy some thyroid cells.
Unfortunately, the stress of either of these methods simply creates more pathological tissue with more nodules. Eventually, the thyroid may need to be removesd if the condition becomes life-threatening. Furthermore, this will only address the symptom while the autoimmune attack continues to progress.
What Causes The Thyroid And Autoimmune Disease?
The question we ask is why would the body start attacking itself? Autoimmune thyroid disease (like other autoimmune diseases ) is the process by which the immune system identifies the thyroid as a foreign agent and produces antibodies against it.
These antibodies launch an attack mode just as when fighting an infection in the body creating an inflammatory response throughout the body
One of these processes is a leaky gut. You might already have heard of this. The commonest cause of leaky gut and autoimmunity is explained here.
Two types of cells in the lining of the intestinal cord are held together by different proteins creating tight junctions throughout the entire intestine to prevent anything permeating or leaking from the gut. If either of these proteins is attacked or weakened, then they will no longer be held together as tightly.
This now allows larger particles that are not supposed to get through to move in and out.
It triggers a corresponding response in the immune system which goes into heightened attack mode to fight them. The attack cells are produced in excess and now also begin to attack other cells.
Leaky gut is indeed a very interesting phenomenon and there is now a lot of research available about it. Now that we understand about the thyroid and autoimmune disease, other causes of leaky gut will be discussed in our next article.
Please leave a comment if you enjoyed reading this article or if you have any questions.
American Thyroid Association (2007) What are Thyroid Problems? https://www.thyroid.org/patient-thyroid-information/what-are-thyroid-problems/q-and-a-autoimmune-thyroiditis/
Grugs (2021) Autoimmune Thyroid Disorders https://www.drugs.com/cg/autoimmune-thyroid-disorders.html