Why is this autoimmune disease so common among women—and what can we do about it?
Women around the world are struggling with Hashimoto’s thyroiditis, one of the most common autoimmune diseases. Many women with Hashimoto’s have a diminished quality of life and a poor understanding of what this diagnosis means, leaving them feeling exhausted and depressed.
Understanding autoimmune thyroid disease
The thyroid, located at the front of your neck, produces hormones that regulate metabolism and energy and is the organ most commonly affected by autoimmune disease.
Two types of autoimmune disease affect the thyroid. The most prevalent is Hashimoto’s thyroiditis, the most frequent cause of hypothyroidism (underactive thyroid). Graves’ disease (autoimmune hyperthyroidism, or overactive thyroid) is less common.
In both cases, the immune system becomes confused and begins producing antibodies that act against the thyroid. These antibodies cause inflammation and tissue destruction and, ultimately, symptoms of thyroid hormone imbalance.
Hashimoto’s is more prevalent in women and in Caucasians, and less so in black and Asian individuals. The rates of Hashimoto’s also increase with age, with most cases diagnosed between 45 and 65 years of age.
Surprisingly, 40 to 60 percent of people with thyroid conditions don’t know they have one—or at least haven’t been diagnosed with one.
Symptoms of Hashimoto’s include weight gain, fatigue, depression, increased sensitivity to cold, joint and muscle pain, dry skin and hair (along with hair loss), and constipation. Brain fog and memory problems, as well as premenstrual syndrome (PMS) or irregular periods, can also be symptoms.
To diagnose Hashimoto’s, a comprehensive thyroid panel is necessary: a thyroid stimulating hormone (TSH) test, along with additional testing, including for the presence of specific autoimmune antibodies, antithyroid peroxidase (TPO) and antithyroglobulin (TgAb).
While the conventional approach to treating all hypothyroidism is to regulate TSH levels with a levothyroxine (Synthroid) prescription, the autoimmune nature of Hashimoto’s calls for a nuanced approach.
For example, people with Hashimoto’s have a higher risk of celiac disease, and research has found everyone with Hashimoto’s can benefit from a gluten-free diet. Avoiding gluten may reduce progression of Hashimoto’s and may reduce autoimmune antibodies. Gluten is found in wheat, rye, barley, and triticale.
Certain supplements may also help.
Selenium is an essential micronutrient, and a lack of dietary selenium can worsen Hashimoto’s. Selenium modifies immune and inflammatory responses in the body and may reduce autoimmune antibodies in Hashimoto’s. Foods rich in selenium are Brazil nuts, sunflower seeds, crustaceans, tuna, mushrooms, and most meats.
Across all ages, low levels of vitamin D are associated with an increased incidence of Hashimoto’s. Vitamin D is a vital regulator of the immune system, and low levels are seen in many autoimmune conditions. Everyone with autoimmune disease should have their vitamin D levels tested and supplement if necessary.
The microbiome, the population of microorganisms in and on our bodies, is a powerful regulator of the immune system. Imbalances in the microbiome, known as dysbiosis, have been found in many autoimmune conditions. Probiotics and fermented foods, which support microbial diversity, may be helpful in treating and preventing autoimmune diseases.
A unique molecule, myo-inositol is involved in regulating the activities of hormones, including TSH. When combined with selenium, myo-inositol may reduce autoimmune antibodies in Hashimoto’s, increase thyroid hormones, and decrease TSH. While it is found in some fruits, beans, grains, and nuts, benefits of myo-inositol have only been found with supplementation.
Autoimmune disease is a group of nearly 100 diseases first recognized only 50 years ago. Autoimmune diseases occur when a perfect storm of genetic predisposition and environmental factors triggers the immune system to turn on the body and destroy tissues.
Hashimoto’s healing plan
Consult your health-care practitioner to determine the right path for you.
- thyroid panel, including TSH, free T3, T4, and thyroid antibodies
- iron and vitamin D
- avoid hormone-disrupting chemicals in personal care products
- exercise regularly
- engage in stress reduction
- eat fermented foods for a healthy microbiome
- vitamin D, if you are deficient
- iron, if you are deficient
- selenium, if your diet is inadequate
- myo-inositol and probiotics may also be helpful
Why is autoimmune disease more common in women?
Autoimmune disease is the fourth leading cause of disability in women. The stronger immune response in women is a major factor, leading to higher rates and severity of autoimmune disease.
Hormones also have a role, as immune cells have receptors for estrogen and progesterone, the main hormones of the menstrual cycle. Estrogen in particular is a strong upregulator of immune function.
Additional exposure to environmental xenoestrogens (chemicals that mimic estrogen in the body)—for example, in women’s cosmetics and body products—can add additional insult. The impact of estrogen on gut bacteria can also lead to changes that leave women more vulnerable to autoimmune disease.