Naperville Integrated Wellness

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What is a Hashimoto’s flare up and what causes it? 

A flare up can cause you to experience symptoms of low/hypothyroid function or high/hyperthyroid function. 

Assuming you have not a recent change in thyroid medication, either by type, brand or dosage, then the cause of the flare up is most likely due to your immune system. 

You must always keep in mind that Hashimoto’s disease is an autoimmune disease. Anything that can alter the state of your immune system can cause Hashimoto’ or any autoimmune disease to flare. 

Common causes of Hashimoto’s flare up

  • Stress 
  • Hormone changes (estrogen, progesterone, testosterone, cortisol, etc.) 
  • Diet, food sensitivities or food allergies 
  • Poor sleep 
  • Gut infections (such as overgrowth of harmful bacteria and or yeast) 
  • Virus infection (see note below on Hashimoto’s and COVID vaccine)
  • Nutrient deficiencies 
  • Chronic pain 
  • Iodine (yes, the most recent research indicates that increasing iodine can be harmful and exacerbate Hashimoto’s disease)

“the addition of iodine to the diet or the administration of iodine-containing medications increases the frequency of ATD and the severity of existing autoimmune thyroiditis.”

There is evidence to suggest that elevated levels of iodide in the diet are associated with autoimmune thyroid disease (ATD) in susceptible individuals, and that autoimmune thyroiditis (Hashimoto’s disease) is less common in susceptible individuals who live in regions with dietary iodine deficiency.

https://pubmed.ncbi.nlm.nih.gov/1345585/

Hashimoto’s and COVID vaccine

Many of my patients with Hashimoto’s have asked me if I think they should get the COVID vaccine. I usually tell them that if they think they should get it, then they should. I also tell them that anything that puts a stress on the immune system can cause their autoimmune disease to flare. 

Autoimmune diseases generally involve difficulties with the immune system turning itself off, so any stimulation of the immune system can sometimes lead to a flare of disease. Vaccines may cause transient flares of disease in some patients,”

https://www.everydayhealth.com/autoimmune-disorders/can-vaccines-cause-autoimmune-disorders.aspx 

There is also some concern about vaccinations and them possibly triggering/causing autoimmune disease…

“Other autoimmune illnesses have been associated with vaccinations. Tetanus toxoid, influenza vaccines, polio vaccine, and others, have been related to phenomena ranging from autoantibodies production to full-blown illness…”  Journal of Autoimmunity.

https://pubmed.ncbi.nlm.nih.gov/10648110/

I do not believe there is an absolute right or wrong answer when it comes to the question of getting the COVID vaccine. I think the individual’s overall health should be considered as well as the interests and personal beliefs of the individual. I do believe that people should consider taking dietary supplements that support the immune system. Such nutrients would include: 

  • Vitamin D
  • Vitamin A 
  • Zinc
  • Vitamin C 

Your immune system requires these nutrients to function properly. If you want to get the vaccine, take these supplements so your immune system can have a more appropriate and beneficial response to the vaccine. 

If you don’t want to the get vaccine, take these supplements so that once again, your immune system has an appropriate and effective response against the virus when you encounter it. 

It should be noted that the most common reason individuals have severe reactions to the virus is because of their immune system; the overreactive and inappropriate response to the virus is what leads to hospitalization or even death. This is why some individuals have had the virus and didn’t even know it (never felt sick) and others have died from it. Same virus…different immune systems. 

Unfortunately, authorities are being vague when it comes the benefits of nutrients and COVID. Here is perfect example from the Mayo Clinic 

“There isn’t enough data to recommend use of vitamin D to prevent infection with the virus that causes COVID-19 or to treat COVID-19, according to the National Institutes of Health and the World Health Organization.”

“The article then goes on to state…

“Other research has observed high rates of vitamin D deficiency in people with COVID-19 who experienced acute respiratory failure. These people had a significantly higher risk of dying. And a small, randomized study found that of 50 people hospitalized with COVID-19 who were given a high dose of a type of vitamin D (calcifediol), only one needed treatment in the intensive care unit. In contrast, among the 26 people with COVID-19 who weren’t given calcifediol, 13 needed to be treated in the intensive care unit.

https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/coronavirus-and-vitamin-d/faq-20493088

This seems pretty clear that taking vitamin D is a good idea. Believe me, if there was a drug that could do this, it would be on every news channel daily, and everyone would be clamoring to get their hands on it…much like the vaccines that are now be offered to some individuals.

Hashimoto’s and Vitamin D

“Patients with Hashimoto’s thyroiditis had significantly lower vitamin D concentrations compared with the controls. Thyroid autoantibodies were significantly decreased by vitamin D replacement treatment in patients with Hashimoto’s thyroiditis.”

International Journal for Vitamin and Nutrition Research

https://pubmed.ncbi.nlm.nih.gov/28697689/

Vitamin A 

“The calming receptor, known as TLR2 (Toll-like receptor 2), uses vitamin A to transmit its signals, which provides an explanation for the connection between vitamin A deficiency and autoimmune diseases.”

https://www.sciencedaily.com/releases/2009/03/090301181421.htm#:~:text=The%20calming%20receptor%2C%20known%20as,lupus%20and%20type%20I%20diabetes.

Zinc

“The meta-analysis results show that, for all models, zinc concentration in serum of autoimmune disease patients was significantly lower than controls. The meta-analysis results show that, for all models, Zn concentration in serum of autoimmune disease patients was significantly lower than controls.”

https://www.mdpi.com/2072-6643/10/1/68/htm

I could go on listing different nutrients and how they help our immune system to function properly, but lets move on to symptoms of a flare. 

Symptoms of a Hashimoto’s flare up 

  • Fatigue 
  • Constipation 
  • Weight gain 
  • Body aches and pains 
  • Hair loss 
  • Hives 
  • Changes in menstrual cycle 
  • Depression 

https://www.healthline.com/health/symptoms-of-hashimotos-flare-up

The symptoms listed above are most consistent with low/hypo thyroid function and the symptoms listed below are generally consistent with high/hyper thyroid function. 

  • Increased heart rate / palpitations 
  • Anxiety 
  • Insomnia 
  • Irritability 

How can you experience symptoms of hypo or hyperthyroidism with Hashimoto’s? 

Hyper-flare

The flare is typically caused by your immune system which triggers a wave of attack on your thyroid gland. This damage to the gland can cause more hormone than usual to be dumped into your bloodstream (provided your thyroid is still making at least some hormone). If you are taking thyroid hormone medication, you will then have fluctuating periods of too much hormone…hormone released from damage to the thyroid + your medication.  You can experience the same symptoms even if you are not taking thyroid medication…same outcome, too much thyroid hormone hitting your system at once…AKA…hyperthyroidism. 

Hypo-flare 

If your flare causes symptoms of hypothyroidism then a different situation is occurring. Again, the immune system is the culprit but now instead of too much hormone in your system, the way your body is using the hormones has changed, making them less effective. This is typically due to the inflammation that occurs with the flare up. An example of this is a reduced ability to convert T4 hormone into the active form called T3 or instead of making T3 your body starts making more rT3 (reverse T3); which essentially blocks the action of T3 hormone. You can also experience symptoms of hypothyroidism simply because of the increased inflammation in the body. This can cause weight gain, fatigue, brain fog, aches and pains or depression even though nothing has changed regarding thyroid hormones. 

Summary

Hashimoto’s disease flare ups are not uncommon and can be of varying intensity. Unfortunately, the traditional healthcare system does not focus on the cause of Hashimoto’s or the flare ups that occur. The only focus is on managing the levels of thyroid hormone. If your TSH and fT4 (free T4) look “normal” then you are told that there is nothing they can do for you. You might end up getting a prescription for Lexapro, Xanax or Ambien, but that is not doing to do anything for the root cause of your problems. The problem is your immune system. 

As a functional medicine doctor, I try to discover the root cause or causes of health issues. The more you can support (not suppress) your immune system the better it will work, and you will have fewer flares and reduce the chances of developing additional autoimmune diseases. 

You do not have an autoimmune disease because your immune system is “overactive” autoimmunity occurs when the immune system loses control, when it fails to regulate itself. 

There is no cure for autoimmune diseases, but we can certainly be more proactive in managing them and improving the quality of life of those who suffer with them. That is my goal as a functional medicine doctor. 

The purpose of functional medicine is: 

Understanding how the body works, knowing how and where to investigate health issues, knowing what to look for, understanding the significance of what is found and creating a plan of action to reverse and correct the root cause the health problems.

My wish for you…health, happiness and a better quality of life! 

If you would like more information about functional medicine and integrative medicine or Dr. Sexton go to napervilleintegratedwellness.com

Do your own research, inform yourself and ask lots of questions. When collecting information, you MUST consider the source. There is no shortage of false, misleading, outdated, profit-driven and utterly biased information in healthcare today; even from the most respected sources and organizations. 

This approach to healthcare is not intended to diagnose, treat, cure, mitigate, or prevent any disease. This article is for information purposes and is not a substitute professional healthcare services. Contact our office for more information.

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