Hashimoto’s Thyroiditis - Part One
The Personal Part
I was first diagnosed with an underactive thyroid in my early 20s, and honestly, I couldn’t have cared less. At the time, it just sounded like a minor inconvenience, take a tiny pill every morning, and everything would be fine. No big deal. So, I kept living my life exactly the same way, eating whatever I wanted, drinking without a second thought, and popping my thyroid meds without ever questioning what was really going on in my body. Slight spoiler alert, not a sensible strategy!
Fast forward a few years, and despite taking my medication religiously, I still felt dreadful. I was exhausted all the time, my weight was creeping up, and brain fog was basically my constant companion. I was working long hours in live TV, burning the candle at both ends, and barely holding it together. Time with my family and friends was sacrificed simply so I could drag myself to work and survive the day.
As more symptoms appeared, joint pain, muscle cramps, debilitating cold intolerance, weakness in my limbs, bloating, memory issues, recurring yeast infections, sinusitis, intense alcohol cravings, a pale, grey complexion with dark under-eye circles, and frequent outbreaks of hives, I finally started to dig deeper.
What was really happening to my body? Why did I still feel terrible despite my treatment?
It wasn’t until I moved to the U.S. in my late 20’s, where I lived for three years, that I finally got answers. Unlike in the UK, where Hashimoto’s isn’t routinely tested for, doctors in the U.S. ran a full thyroid panel, including antibody tests. That’s when I finally received the correct diagnosis, Hashimoto’s Thyroiditis, an autoimmune condition that was slowly destroying my thyroid.
Autoimmune diseases, like Hashimoto’s, occur when the immune system mistakenly attacks the body’s own tissues, in this case, the thyroid (1)(2). This loss of “self-tolerance” leads to chronic inflammation, which not only damages the thyroid gland but can also cause widespread symptoms throughout the body (3). Inflammation is at the core of autoimmunity, and when left unchecked, it can contribute to everything from digestive issues and joint pain to neurological symptoms like brain fog and mood disorders (4). Research indicates that a combination of genetic predisposition and increased intestinal permeability, commonly referred to as “leaky gut”, may play a significant role in triggering autoimmune conditions like Hashimoto’s. When the gut lining is compromised, it allows larger molecules such as undigested food particles, bacteria, and toxins to pass into the bloodstream. This can provoke an immune response that mistakenly targets the body’s own tissues.
The interplay between a leaky gut and genetic susceptibility may help explain why some individuals develop Hashimoto’s, while others with similar genetic backgrounds and environmental exposures do not (1,5). I quickly realized how fortunate I was to have received a diagnosis at all. In the UK, testing for thyroid antibodies is rarely offered, meaning many cases of Hashimoto’s go undetected. Instead, doctors typically assess only thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels, which do not reveal the underlying autoimmune condition. Because of this, the thyroid can remain under attack for years while still producing enough hormone to appear ‘normal’ on standard tests. Only when it can no longer compensate does hypothyroidism get diagnosed, without acknowledging the autoimmune cause. As a result, the underlying inflammation continues unchecked, and countless people unknowingly struggle with Hashimoto’s, dismissing their symptoms as merely a part of everyday life and their risk for developing further autoimmune issues is increased (6).
Well, isn’t everyone tired, stressed, achy, or a bit down and anxious? At least, that’s what you’re told and often by your GP. But the truth is, no, not everyone feels this way and it shouldn’t just be dismissed. While these feelings are common, they’re not normal when they persist. You shouldn’t just accept them as an inevitable part of life or let them be brushed off as nothing. Ongoing fatigue, low mood, and anxiety can be signs of a deeper issue and one that deserves to be taken seriously and properly investigated.
My experience of finally getting the right diagnosis was life-changing. It explained everything I had been going through, and set me on a path to research, training and truly understanding how to manage my health. But, it also made me realise just how many people might still be struggling in the dark, not knowing that Hashimoto’s could be at the root of their symptoms and leaving themselves at risk of further autoimmune issues.
No Two Hashimoto’s Patients Are Alike
One of the most frustrating aspects of Hashimoto’s is how differently it presents in each person. While the underlying autoimmune attack on the thyroid gland is the cause, the symptoms can vary widely because every cell in the body relies on thyroid hormone. This means that Hashimoto’s can affect any single person in differing ways with symptoms that range from head to toe (7)(8).
The Common Thread: A Body in Slow Motion
In Hashimoto’s, the gradual destruction of the thyroid leads to a state of hypometabolism, a systemic slowdown that affects nearly every function in the body. This isn’t just about weight gain or sluggish digestion; it’s a whole-body impact. From brain fog, memory issues, and low mood to slow heart rate, dry skin, hair thinning, menstrual irregularities, and cold intolerance, every cell and organ depends on thyroid hormones to function optimally. When those hormones drop, everything slows down. It’s like trying to run a complex machine on low power. This widespread hypo-metabolic state can leave people feeling like they’re falling apart piece by piece, often without understanding that an underperforming thyroid could be at the root of it all or, more importantly, that it is autoimmunity at play.
What I typically see in clinic alongside the more classic symptoms of weight gain, cold intolerance and fatigue are:
Cognitive slowing – brain fog, memory lapses, difficulty concentrating, low mood and anxiety.
Digestive sluggishness – bloating, constipation, food intolerances, low stomach acid, excess wind, low appetite, fullness, candida and SIBO.
Low energy production – muscle weakness, lack of stamina, cold or heat intolerance, increased need for sleep, unrefreshing sleep, lack of dreaming.
Reduced detoxification – increased sensitivity to toxins and poor liver function, acne, dark eye circles, itchy skin, alcohol intolerance.
Musculoskeletal issues – cold hands and feet, dry skin, hair thinning, brittle nails, itchy skin, muscle twitching, regular cramp and achy muscles/joints.
Hormone issues – heavy periods, disrupted menstruation, severe PMS,
Multiple signs of nutrient depletions – various
Digging Deeper
Understanding this pervasive hypometabolic state means managing Hashimoto’s requires more than just replacing thyroid hormone. While medication can be helpful, it doesn’t address the underlying factors that triggered the autoimmune response in the first place. When it comes to Hashimoto’s, there is no one-size-fits-all approach. Effectively managing or treating Hashimoto’s means going beyond just identifying what triggered the condition, it also requires uncovering what’s continuing to drive it. While initial triggers like infections, “leaky gut”, environmental toxins, food sensitivities, or stress may have set off the autoimmune response, the disease often persists due to ongoing factors (9). These can include chronic inflammation, ongoing gut issues, nutrient deficiencies, hormonal imbalances, or impaired detoxification. To truly stop the progression and support healing, it’s crucial to address both the root causes and the elements that are still fuelling the immune attack. A personalised whole-body approach is key to restoring balance and long-term thyroid health.
In Part 2 of this blog, I’ll dive deeper into key insights drawn from my personal journey, in-depth research, and clinical experience working with hundreds of individuals with Hashimoto’s. We’ll explore the critical role that diet, lifestyle interventions, and comprehensive testing play in effectively managing this condition.
While receiving a proper diagnosis is an essential first step, the true transformation happens when you begin addressing the root causes, empowering you to slow, or even stop, the ongoing damage to your thyroid.
Academic References:
2. Leaky Gut and Autoimmune Diseases
3. Autoimmune Diseases: The Failure of Self-Tolerance
4. From Autoinflammation to Autoimmunity: Old and Recent Findings
5. Genetic Basis of Autoimmunity
7. Clinical Manifestations of Hypometabolism in Women
9. Hashimoto’s Thyroiditis: An Evidence-Based Guide to Etiology, Diagnosis, and Treatment