Hashimoto’s thyroiditis is the leading cause of hypothyroidism.
In Hashimoto’s the immune system becomes overactive and inflamed, leading to chronic stress on the thyroid gland, hormonal imbalances, and gradual tissue damage. Over time, this persistent immune response interferes with the thyroid’s ability to function properly, reducing hormone production and leading to hypothyroidism, which slows metabolism and affects nearly every system in the body.
Many people with Hashimoto’s experience fatigue, weight gain, brain fog, cold intolerance, hair thinning, and digestive issues, often long before traditional lab tests show significant abnormalities.
Conventional medicine frames autoimmunity as the body mistakenly attacking itself, but I see it differently. Rather than an error, these reactions may be a sign that the body is struggling to heal under less-than-ideal conditions. When the immune system is overwhelmed by chronic stress, environmental toxins, nutrient deficiencies, or hormonal imbalances, it may react aggressively, not out of self-destruction, but as an attempt to restore balance.
The body is always working toward homeostasis, but when it lacks energy or nutrients or is overloaded with toxins, this process can become dysregulated and prolonged. Instead of efficiently resolving inflammation, the body gets stuck in a cycle of immune activation, leading to tissue damage.
Many people think of Hashimoto’s as a condition that permanently damages the thyroid, but the thyroid has the ability to regenerate. Research suggests that thyroid function can improve when inflammation is reduced, metabolic function is restored, and the immune response is rebalanced. This means that healing is possible, even after years of thyroid dysfunction.
It’s always important to remember that with any chronic condition, lifestyle changes are necessary. Diet is usually one of the most important factors, as what we eat directly influences inflammation, immune function, and thyroid hormone production. Addressing stress, blood sugar balance, digestion, and nutrient deficiencies play a huge role in managing symptoms and supporting thyroid function.
There’s no one size fits all approach, but there are a lot of things we can do to help restore balance and improve how you feel.
So, what can we do to help restore balance and reduce the immune system’s overactivation?
- Natural desiccated thyroid:
Hypothyroidism is a defining feature of Hashimoto’s, so thyroid hormone supplementation is often needed. I prefer a combination of T3 and T4 to ensure the body receives both the inactive storage form (T4) and the active, metabolically potent form (T3). Many people with Hashimoto’s struggle to convert T4 into T3 efficiently, making T4-only medications like levothyroxine insufficient. Natural Desiccated Thyroid (NDT) provides a more complete hormonal profile, including precursors T1 and T2
Supplementing with the right balance of thyroid hormones helps reduce stress on the thyroid gland, supports metabolism, and alleviates symptoms like fatigue, brain fog, and cold intolerance.
NP Thyroid, Armour Thyroid, or OTC NDT like Raena’s contain T3 and T4 and are great options.
- Low dose naltrexone:
Low Dose Naltrexone (LDN) is an off-label use of naltrexone, traditionally prescribed at higher doses for opioid and alcohol dependence. Since the 1980s, medical providers have been prescribing LDN for autoimmune conditions.
At doses typically ranging from 0.5 to 4.5 milligrams, LDN has potential immunomodulatory effects by temporarily blocking opioid receptors, leading to a rebound increase in endorphin production.
Endorphins play a key role in regulating the immune system, reducing inflammation, and promoting T-regulatory (Treg) cell activity, which helps prevent excessive immune attacks on healthy tissues. LDN has also been shown to lower pro-inflammatory cytokines, such as TNF-α and IL-6, which are often elevated in autoimmune conditions.
- Progesterone:
Women are up to 10 times more likely to develop Hashimoto’s than men. This is partly due to the influence of estrogen, which affects immune function and increases thyroid autoantibody production. The interaction between hormones and immune responses makes women more vulnerable to autoimmune diseases in general.
“Estrogen blocks the release of hormone from the thyroid gland, and progesterone facilitates the release. Estrogen excess or progesterone deficiency tends to cause enlargement of the thyroid gland, in association with a hypothyroid state” (Dr. Ray Peat, PhD)
Supplementing with progesterone can help to:
- Counteract estrogen’s suppressive effects on the thyroid, allowing for better thyroid hormone release and utilization.
- Reduce thyroid autoimmunity, as progesterone helps modulate the immune system and lower inflammatory cytokines that contribute to Hashimoto’s.
- Improve T4-to-T3 conversion, since progesterone supports liver function, where much of this conversion takes place.
- Lower thyroid-binding globulin (TBG), increasing the amount of active thyroid hormone available to cells.
- Protect against cortisol and stress hormones, which can suppress thyroid function and contribute to autoimmunity.
- Support metabolic function, reducing common Hashimoto’s symptoms like fatigue, cold intolerance, and brain fog.
Many people with Hashimoto’s experience chronic fatigue, brain fog, and sluggish metabolism, yet standard lab tests may not reveal a true thiamine deficiency. This is known as functional thiamine deficiency.
Supplementing with high-dose thiamine helps restore energy by bypassing metabolic bottlenecks and supporting ATP production. It enhances GABA and dopamine activity, which may improve focus, memory, and mental clarity.
Thiamine plays a role in reducing inflammation by lowering pro-inflammatory cytokines like TNF-α and IL-1β, which are often elevated in Hashimoto’s and contribute to thyroid damage
Hashimoto’s is linked to celiac disease and gluten sensitivity. Research suggests that people with Hashimoto’s are significantly more likely to have gluten-related disorders due to molecular mimicry, where the immune system mistakenly attacks the thyroid because of similarities between gluten proteins and thyroid tissue.
In addition to triggering an autoimmune response, gluten can also contribute to intestinal permeability (“leaky gut”), which allows undigested proteins, toxins, and inflammatory compounds to enter the bloodstream and further fuel immune system overactivation. Many with Hashimoto’s report symptom improvement when removing gluten, and some studies suggest that a gluten-free diet may help reduce thyroid antibodies and inflammation.
- Lowering stress:
Almost every autoimmune condition is linked to stress and high cortisol. Chronic stress elevates cortisol, which suppresses thyroid hormone conversion (T4 to T3) and weakens the immune system’s ability to regulate itself.
High cortisol raises blood sugar, increases estrogen dominance, and depletes progesterone, all of which contribute to immune dysregulation. Elevated stress hormones can also increase intestinal permeability (“leaky gut”), allowing inflammatory compounds and toxins to further drive the autoimmune response. Lowering cortisol often requires significant lifestyle adjustments, but some effective strategies to help manage it include:
- Eat every 3-4 hours to keep blood sugar stable
- Avoid excessive fasting or low-carb diets
- Get morning sunlight
- Spend as much time in nature as you can
- Address emotional health and relationships
- Ensure adequate sodium, potassium, and magnesium intake help regulate cortisol
- Lymphatic drainage and massage:
The original name for Hashimoto’s thyroiditis was “struma lymphomatosa,” a term given by Dr. Hakaru Hashimoto when he first described the condition in 1912. In Latin, “struma lymphomatosa” translates to “lymphoma-like swelling” or “swollen lymph gland mass.”
The lymphatic system is responsible for clearing cellular waste, toxins, and immune byproducts, so when it becomes sluggish, inflammation lingers, immune cells accumulate. The thyroid can be affected, especially because there are so many lymph nodes and vessels surrounding the gland.
Lymphatic massage and drainage techniques around the neck may help:
- Reduce swelling and fluid retention in the thyroid area.
- Encourage the removal of inflammatory byproducts and immune cell waste.
- Support detoxification by improving circulation and lymph flow.
- Relieve pressure and discomfort associated with thyroid inflammation.
