Issue 3: Ignorance of Hashimoto’s thyroiditis autoimmunity

Hashimoto's Thyroiditis
Hashimoto’s Thyroiditis: an autoimmune condition.

This series of 6 blog posts tells my story and outlines the six challenges I’ve faced.

This post focuses on the importance of understanding and diagnosing a special type of hypothyroidism, Hashimoto’s thyroiditis, which is actually the most common cause of hypothyroidism.

At almost every turning point in my experience with Hashimoto’s thyroiditis, I have had to do my own research and take initiative to ask my doctors for tests that should have been done years earlier.

On top of my hypothyroid symptoms (during treatment as well as pre-treatment) and the fact that chronic hypothyroidism increases risk for other health issues (such as heart problems), I have struggled with systemic barriers in the health care system:

  1. Delayed diagnosis of hypothyroidism
  2. Misdiagnosis of thyroid-related depression
  3. Ignorance of Hashimoto’s autoimmunity
  4. Lack of regular (or any!) thyroid ultrasound testing
  5. Lack of testing for Free T3 and Reverse T3 levels
  6. Lack of referral to an endocrinologist who understands

Let’s dive into part three.

Issue 3. Ignorance of Hashimoto’s autoimmunity

Around 2003 I commenced Synthroid treatment.  However, I was never tested for thyroid antibodies and told whether my thyroid inflammation and hypothyroidism was due to having Hashimoto’s. I finally requested an antibodies test from a naturopath in 2013.

Why is it important to know whether your thyroid condition is caused by autoimmunity?

I already had another autoimmune disorder, an arthritis condition called Ankylosing Spondylitis. As a caretaker of my own body, should I not be made aware of how important it would be for me to build up and maintain my body’s immune system?  How would you like to have symptoms of two autoimmune disorders at the same time?  During an autoimmune flare up, it’s hard for the patient but also confusing for the doctors to sort out what is going on.

Also, Hashimoto’s thyroiditis flare-ups may cause swings from hypo- to hyper-thyroid symptoms. This variability is caused by changing levels of autoimmune attack. It may predict a difficult journey of adjusting dosages to manage symptoms. It may require more frequent testing, since the same dose may result in hypothyroidism or hyperthyroidism depending on the level at which the thyroid is able to function.

A diagnosis of autoimmune Hashimoto’s thyroiditis also comes with dietary cautions about gluten and iodine. (See Dr. Datis Kharrazian’s blog post “Changing your diet is the first step in addressing Hashimoto’s“). These are unique elements of treatment that may not apply to patients who are hypothyroid due to an merely “underactive” thyroid or surgically removed thyroid.

If I had known I had autoimmune thyroiditis, I could have, and should have, adjusted my diet and supplements in addition to taking medication.

And finally, and most importantly, people with Hashimoto’s are at increased risk for cancers in the thyroid, as well as colorectal cancer. (Chen, et al, 2013).

Therefore, this leads to the next issue:

Next post:  Issue 4: Lack of regular (or any!) thyroid ultrasound testing

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