What Are Some Common Autoimmune Conditions That Affect The Thyroid Gland?
Hypothyroidism and hyperthyroidism are quite commonly known, and understood by us.
However, we often don’t know, or understand the root cause of the thyroid imbalance. In some cases, autoimmune conditions do affect the thyroid gland, and cause the body’s immune cells to attack the gland.
Hashimoto’s Thyroiditis and Graves’ Disease are two manifestations of such an autoimmune condition. In Hashimoto’s Thyroiditis, the body’s immune system attacks the cells of the thyroid gland, causing a decrease in the production of thyroid hormones. The most common cause of hypothyroidism in the U.S. is Hashimoto's disease.
In Graves’ Disease, the body’s immune system mimics the stimulant hormone that tells the thyroid to produce hormones, and as a result, more thyroid hormones than usual are produced. This is the most common cause of hyperthyroidism in the U.S.
The exact cause of Hashimoto’s disease (one cause of hypothyroidism) is not known yet. However, we do know that in this condition, the body’s immune cells product specific chemicals (antibodies) that attack and destroy the thyroid gland. But, why the immune system behaves so is still under study and researchers believe a lot of factors contribute to it.
Some of the risk factors under study are:
- Heredity – A family history of Hashimoto’s disease puts you at a high risk of getting it.
- Autoimmune diseases – Sometimes this disease is triggered by other autoimmune diseases like type 1 diabetes, rheumatoid arthritis, or lupus.
- Gender – Women are more susceptible to Hashimoto’s than men.
- Age – Middle-aged people are more at a risk of getting Hashimoto’s disease.
- Radiation – Constant exposure to high levels environmental radiation also increases the risk.
Graves’ Disease is caused by the immune system producing an antibody that behaves like the thyroid stimulating hormone (TSH). This antibody, known as the thyrotropin receptor antibody (TRAb) overrides the pituitary function, causing hyperthyroidism.
The risk factors associated with Graves’ disease are:
- Family history – With a family history of Graves’ disease, you fall into the high risk category.
- Autoimmune disorders – Having other autoimmune disorders like type 1 diabetes or rheumatoid arthritis puts you at an increased risk of Graves’
- Gender – Women are more likely to have this disease.
- Age – If you are younger than 40, then you may develop Graves’ disease more quickly.
- Stress – Both emotional as well as physical stress can result cause the disorder.
- Smoking – Smokers have a greater risk of developing Graves’
- Pregnancy – Pregnancy as well as childbirth can trigger this disease, especially if you have a family history.
While a few people with a mild form of the disease may not show any symptoms, the normally observed symptoms are:
- Mild or unexplained weight gain
- Dry skin
- Dry, and/or thinning hair
- Enlarged thyroid, or goiter
- Pale, puffy face
- Irregular and heavy menstruation
- Cold intolerance
- Muscle aches
- Brittle nails
- Memory lapse, or brain fog
In Graves' disease, the symptoms are usually clearly visible such as:
- Hand tremors
- Altered heartbeat or palpitations
- Heat sensitivity
- Sweating excessively
- Frequent bowel movements
- Difficulty in sleeping
- Altered, scanty menstrual cycles
- Erectile dysfunction in men
- Goiter of the eyes
- Vision issues
The doctor will study your symptoms, and family history and then decide the tests to be done.
The usual test done for a thyroid disorder is:
- Blood Test: The blood test is done to understand the TSH (Thyroid Stimulating Hormone) levels in the body. Along with this the levels of the thyroid hormones: thyroxine (T4) and triiodothyronine (T3) are also studied. Increased TSH levels and low T3, T4 levels indicate the presence of disease.
- Further, if Hashimoto’s is suspected, a TPO antibody test can conclusively show the presence of antibodies attacking the gland.
- A FNAC (Fine Needle Aspiration Cytology) test may be recommended to study the extent of damage to the thyroid gland.
In this, a physical examination may yield a lot of clues to the doctor like an enlarged thyroid gland, bulging eyes, and increased pulse rates or blood pressure. Apart from family and medical history, the doctor may order a blood test.
- Blood Test: In this case, a high T4 level as well as a low TSH level will indicate the disease’s
- Radioactive iodine uptake test: This is another test that may be administered to measure your thyroid iodine uptake. A high uptake of iodine is observed with Graves’ disease because more of the hormone is being produced.
Treatment (Medication) - Allopathy, Homeopathy, Ayurveda
Allopathy believes that this disease has no cure and hormone replacement medication is usually prescribed life. The treatment is usually aimed at raising thyroid hormone levels or lowering TSH levels as required. The medicines may also help relieve the symptoms.
In very advanced cases, surgery to remove a part or all of the thyroid gland may be done.
Ayurveda considers this disease as a bodily imbalance (either Pitta or Vata) and suggests diet, lifestyle changes and herbal medicines aimed at restoring the same.
While each individual case may be different and would need a one-on-one consultation to decide on the treatment, in general, the prescribed diet includes:
- Regular, warm meals that are easy to digest (soups, stews, creamy foods)
- Sweet, sour and salty foods
- Herbs such as cumin, ginger, turmeric, cinnamon, mustard, rosemary and sage
- Herbal teas with chamomile, ginger, cinnamon and clove.
Mindful eating is advised, and cold and raw foods as well as juices are to be avoided. It is advised to get a warm sesame oil massage.
In a clinical study conducted to study the efficacy of Homeopathy on Hashimoto’s disease, it was found to be beneficial.
The benefits were not just in achieving hormone control, but also in emotional stability, reduced sleepiness, improvement in quality of life, and reduced dryness of skin and hair as well as hair loss.
The medicines listed in the study are:
- Natrum muriaticum
- Baryta muriatica
- Calcarea carbonica
- Calcarea fluorica
There is no cure for this disease in allopathy so far. However, symptoms can be controlled and the disease can be managed using certain therapies.
Listed below are the conventional treatment options:
- Beta-blockers: These are used to control the rapid heart rate, anxiety, and sweating symptoms.
- Antithyroid medications: These prevent the thyroid from excessive hormone production.
- Radioactive iodine: This is used to destroy all or part of your thyroid, if required
- Surgery: In extreme cases, surgery may be done to remove the thyroid gland, if all other drugs and therapies cannot be used.
Ayurveda helps to balance the thyroid secretion using herbs, controlled diet and lifestyle changes. This is said to be the result of vata and pitta dosha and hence these doshas are treated.
The suggested medicines are:
- Kanchanara: Helps in T4 to T3 conversion without increasing TSH levels.
- Jatamansi: Helps in regulating stress and pitta
- Brahmi: Balances pitta and unblocks nervous, circulatory and digestive channels.
Warning Box: All these medicines should be only taken in consultation with a qualified Ayurvedic practitioner. Indiscriminate use of ayurvedic herbs can have severe, systemic side effects.
Homeopathy suggests a holistic, individualistic approach to treating Graves' disease. It treats the disease as well as the underlying causes.
A few suggested medicines are:
- Calcarea Carb
- Nux Vomica
Warning Box: All these medicines should be only taken in consultation with a qualified Homeopathic practitioner as treatment is highly individualized. Do note that homeopathic treatment may take some time to work. Hence, always keep your diagnosing doctor in the loop and handle symptoms as and when they arise.
A good, healthy diet that includes foods that do not contribute to the bodily imbalances is what is encouraged in this disease.
It is best to avoid cold foods and stick to warm meals and include some herbs and spices like turmeric, cinnamon, rosemary, sage etc. in your foods. Also herbal teas can help.
Some studies suggest that vegetables in the cabbage family such as cauliflower, brussels sprouts, etc. are not good for thyroid function. However, in their cooked form, they are considered harmless in the disease’s progression.
Nutrition for Graves' disease is aimed at providing antioxidants and nutrients that help alleviate the symptoms.
- Gluten containing foods like wheat, rye, barley, etc.
- Consume in moderation or only as required as per the doctor’s instruction
- Meat, especially red meat
- Calcium rich foods like broccoli, almonds, kale, sardines, etc.
- Vitamin D foods like cod liver oil, salmon, tuna and mushrooms.
- Magnesium-high foods like avocados, Brazil nuts, dark chocolate, cashews, pumpkin seeds, etc.
- Selenium containing foods like brown rice, sunflower seed, etc.
Exercise is good for Hasimoto’s disease and the advice is:
Gentle exercise like stretches, yoga, or Tai Chi
Quick, brisk walks
Mini massages for stiffness and lethargy
Patients with Graves' disease can benefit a lot from exercise.
The American College of Sports Medicine recommends aerobics, for 30 to 60 minutes a day for 5 days a week. These could be in the form of dance classes, swimming, or biking.
Also, resistance training like pushups or sit-ups and walking or climbing stairs is suggested. It is best to discuss with the doctor on what to adapt and how much.
A regular lifestyle with regular sleep, planned work balanced with rest and breaks is advised. Stress should be avoided and stress management options like meditation, aromatherapy, listening to calming music, etc. should be followed on a regular basis. Also, take breaks if you work with screens.
Lifestyle changes for people with Graves' disease include following suggested diets strictly, and getting ample exercise. Stress management using techniques like meditation, aromatherapy, massage, acupuncture, etc. can be tried. Quitting smoking and avoiding environmental toxins like pesticides, air and water pollution, etc. also helps.
How to Prevent These Disorders?
This disease cannot be prevented and can only be treated, especially early to ensure that the disease is controlled. So, please visit a doctor if you suspect that any of the symptoms could point to hypothyroidism.
Graves' disease is also not preventable. However, people in the high-risk category can take some precautions like quitting smoking and undergoing regular checkups for early diagnosis. The disease is treatable to an extent and manageable with early diagnosis.