Complaints & connections · borters.ch
The immune system attacks the thyroid — a slow process that can be well monitored and balanced when needed.
Also known as: Hashimoto’s thyroiditis · autoimmune thyroiditis · common cause of hypothyroidism
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The thyroid sits at the front of the neck and makes two hormones, T4 and T3, which help set the pace of almost every cell. In Hashimoto’s the immune system turns against that tissue over years; in countries with enough iodine it is the commonest cause of an underactive thyroid. Three things are regularly muddled. First the antibodies: TPO antibodies show that an autoimmune process is running — they say nothing about function, they are not treated, and their course does not need repeat measuring. Many people carry them lifelong without ever becoming underactive. Second the TSH: it does not come from the thyroid but from the pituitary, and it rises when too little hormone arrives. A high TSH therefore means a weak thyroid, not an overactive one — that reversal confuses almost everyone at the first report. Third the course: it is rarely a straight line. Early on function can be normal, occasionally even too high for some weeks, before it slowly fades. So it is monitored rather than settled once. The complaints themselves are unspecific and overlap with iron deficiency, anaemia, low mood and the menopause — the value decides, not the feeling.
Over- or underactivity should be diagnosed and treated (e.g. hormone replacement) — the key step.
Iodine is the building block of thyroid hormones; both deficiency and excess can harm. Iodised salt and sea fish cover the need.
Feeling cold does not prove the thyroid. The most common other reasons are an empty iron store and a vitamin B12 deficiency — both produce the same cold and the same tiredness. With autoimmune thyroiditis they come along more often, because the same immune situation can affect the stomach lining, and then less iron and B12 is taken up. Ferritin and B12 show whether something is missing there.
TSH alone only says how loudly the pituitary is calling. Only with free T4 beside it does it become visible whether too little hormone really arrives or only the signal is raised.
TPO antibodies answer the question of cause. They steer no treatment, and their level says nothing about today’s complaints or about what comes next.
TSH swings through the day and is highest in the morning. Measuring once in the morning and once in the afternoon compares two different things and may change a dose because of the clock.
Calcium and iron supplements bind the hormone in the gut, coffee delays uptake. A steady gap matters more than a perfect one — the main thing is that it is the same every day.
Studies show selenium can lower antibody levels. Whether complaints or the course change with it is not shown by the studies. A high intake kept up for long is not harmless either.
Iodised salt and sea fish are a different order of magnitude from algae powder or iodine preparations. Large amounts can trigger or worsen an underactive thyroid in a gland already affected.
In pregnancy the targets are tighter and the need often rises within the first weeks. Anyone with antibodies should discuss this before, not after, conception.
Autoimmune processes cluster: coeliac disease, vitamin B12 deficiency from autoimmune gastritis, vitiligo, type 1 diabetes. That does not mean they will come — only that they belong in mind when new complaints appear.
Levothyroxine replaces the hormone the thyroid no longer makes in sufficient amount. The autoimmune reaction itself is untouched — it carries on, only without consequences for metabolism. That is why the value is checked, not the feeling.
The most common thyroid condition; women are affected five to ten times more often than men. The underactivity develops over years, often without any single day standing out. After a dose change the value only becomes meaningful again after six to eight weeks.
Not a dip after one bad night but a background state over weeks. That is exactly why it proves nothing on its own — iron deficiency and anaemia feel the same.
Cold hands and feet, a jumper in summer. The body turns its turnover down when less hormone arrives.
Skin and hair renew more slowly. The hair does not go bald in patches but thins overall, and it comes back when function is right again.
The whole digestive route slows down. Constipation with no other explanation is therefore a reason to look at the thyroid once.
An underactive thyroid explains a modest gain, usually a few kilos, part of it retained water. A large weight gain almost always has another cause — here the thyroid is more often a suspect than the culprit.
Finding words, concentration and drive all fade. That is why thyroid values are measured alongside a new depressive episode.
The gland can swell in the inflammatory phase and shrink later. A rapidly growing, hard or one-sided nodule needs looking at regardless.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
In studies with 200 µg selenium a day over 3–6 months antibodies fell; whether thyroid function benefits is open. Above 300 µg a day long term counts as too much.
Very high iodine amounts can weigh on the course of Hashimoto, and so can deficiency. Normal iodised-salt amounts are not meant; high-dose seaweed preparations are.
With coeliac disease alongside, avoidance is needed. Without it small studies give mixed results; anyone trying should hold it for 3 months and then judge by the antibodies.
The best-studied supplement in this condition — the antibodies fall in studies, the wellbeing not always.
A gluten-free diet is much recommended; it is established only with coexisting coeliac disease, which is more common here.
TCM does not know autoimmune disease — it describes what the person feels: cold, heaviness, exhaustion. That does not replace the TSH value, it describes alongside it.
The most important entry on this page: some Chinese herbal mixtures contained aristolochic acid — it caused kidney failure and cancer in Europe. Anyone taking Chinese herbs buys where the origin is checked.