Will You Become Hypothyroid?

The two main markers that usually lead to hypothyroidism are elevated thyroid antibodies and TSH. Here we discuss simple, effective strategies to help lower your thyroid antibodies and help prevent hypothyroidism.

If you need help managing your thyroid health, click here

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Will You Become Hypothyroid?

Dr. Michael Ruscio: Will I become hypothyroid?

Hi, this is Dr. Ruscio, and let’s discuss this question because it is, understandably so, a very common and very important question, which is, will I become hypothyroid?

Now, hypothyroidism is when the thyroid gland in the base of your throat does not produce adequate thyroid hormone. This can lead to things like fatigue, weight gain, slowed or impaired digestion or constipation, dry hair, dry skin, dry nails, high cholesterol, and low sex drive. It’s certainly a line of symptoms that are fairly common, which is why many people will be very quick to suspect hypothyroidism as the underlying root cause of their illness, so this is a common question.

Now, there are two factors that really predict hypothyroidism. These are thyroid antibodies and TSH. The most common cause of hypothyroidism in most Westernized countries is an autoimmune process in which your immune cells attack your thyroid gland, cause damage to the thyroid gland, and that eventually causes one to become hypothyroid. These antibodies, which diagnose usually what’s known as Hashimoto’s or an autoimmune thyroid condition, these antibodies can lead to gradual deterioration of the gland and subsequent hypothyroidism.

Also TSH can predict hypothyroidism. TSH is the molecule that travels from the brain to the thyroid, that tells the thyroid to make thyroid hormone. If this molecule, this TSH, signals, the higher this TSH goes, it means the louder the brain has to yell to the thyroid to get the thyroid gland to make hormone. If the thyroid gland is sluggish, it’s kind of like the brain is the jockey having to whip the horse harder and harder in order to get it to run. The higher the TSH goes, that means the louder the brain has to yell down to the thyroid to get the thyroid to make adequate thyroid hormone.

When people are concerned about a thyroid condition, they will often have either their TSH and/or their antibodies run. It’s not uncommon for someone to see a mild elevation of one or both of these. The question then is, how do I know if I will eventually become truly hypothyroid? How do I know if a mild elevation of these antibodies or the TSH will predict hypothyroidism, and what can I do about it?

Well, we do have evidence that shows that the higher the level of the antibodies and/or the TSH, the higher the level, the greater the likelihood someone will progress to overt hypothyroidism where they require thyroid hormone replacement or thyroid hormone medication.

Now, this is important because there are interventions that can help lower the antibodies. There’s not as much information that we have that shows that we can lower the TSH, although I think what applies to the antibodies, which we’ll talk about in a second, would likely apply to the TSH. Again, we know that the higher the antibody levels are that that has a higher prediction for future hypothyroidism. Then the question is, are there any things that we can do to lower thyroid antibodies?

The thing that you’ve probably heard of is going on a gluten-free diet, and certainly there seems to be a wealth of anecdotal reports showing that when people go on gluten-free diets, it helps with thyroid antibodies. This is probably because people with celiac disease or increased or frank gluten intolerance have a higher incidence of thyroid autoimmunity, and there may be some linkage between the two. We also know that even if you don’t have full-blown celiac disease, you may have something known as non-celiac gluten sensitivity, which is a lesser form of gluten intolerance, if you will. This may be why people that aren’t full-blown celiac but go on a gluten-free diet notice an improvement in their thyroid antibodies. So one option to lower your antibodies is going on a gluten-free diet, and I would argue that just improving your diet, in general, because there’s probably not much that eating a healthier diet doesn’t have a chance to at least help.

Now, secondly, there is also the treatment of gut infections, which is something that I talk a lot about in one of my main areas of focus, improving the health of the gut, because this has a large impact on the immune system, and we do have some initial published evidence, for example, showing that treating an H. pylori bacterial infection has been shown to lower the levels of the antibodies. Why is all this relevant? Well, if we know that the higher the antibodies, the higher the likelihood of subsequent hypothyroidism, then perhaps by lowering the antibodies and using interventions to lower the antibodies as much as we can, we can prevent future progression to hypothyroidism.

Now, we don’t have a lot of studies that have looked at this specifically except for one, which we reviewed recently, which showed that a supplemental combination of magnesium, CoQ10, and selenium—and selenium may be the one that has the most impact—lowered thyroid antibodies and had a positive effect on the actual tissue of the thyroid gland. When they used ultrasounds to monitor how healthy the thyroid tissue was, they showed that over time people with thyroid autoimmunity actually saw a preservation or even a reversal of thyroid damage.

Again, we have diet, we have treatment of infections, and we have supplementation that may be helpful. Another reason why this may be relevant is sometimes patients are frustrated because a more conventionally trained doctor does not really look at the antibodies. This is something that may need to be reexamined in light of some of this emerging evidence showing that interventions that lower the antibodies, one, that the higher the antibodies, the higher the likelihood of hypothyroidism, and then, two, there are interventions that can lower the antibodies, and then, three, some of these interventions have shown the ability to preserve thyroid gland structure and function and that potentially prevent progression to subsequent hypothyroidism.

Now, admittedly, these studies are preliminary, and there’s not a wealth of scientific support here. However, we’re trying to justify things like a healthy diet, very inexpensive nutritional supplements, and treatment of gastrointestinal infections that shouldn’t be there in the first place, so these are interventions that make a whole heck of a lot of sense, and we don’t really need a very robust scientific support to justify them. If we were trying to recommend a surgical procedure, then, yes, we would probably want to be quite a bit more conservative in our recommendations and lean more heavily on scientific support. In this case, we do have some scientific support. It is preliminary, but it reinforces very safe treatments that may have a very positive impact on someone in the long term.

In recap, the higher the levels of TSH and/or thyroid antibodies, the higher the risk that one will later progress to hypothyroidism. There are interventions that one can use to lower the antibody levels, which are diet, treatment of gastrointestinal infections, and nutritional supplements. Some preliminary evidence suggests that by doing this, by lowering the antibodies, you may be able to preserve the structure and function of your thyroid gland and prevent subsequent hypothyroidism.

This is Dr. Ruscio. Hopefully this information helps you get healthy and get back to your life. Thanks.

If you need help managing your thyroid health, click here

What do you think? I would like to hear your thoughts or experience with this.

Discussion

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8 thoughts on “Will You Become Hypothyroid?

  1. Good information. I am curious then at what point then is it considered hypothyroidism or in fact Hashimoto’s? My husband has high TSH and and high antibodies but to date is not on medication.

    What then becomes the marker to know when he has tipped over the edge?

    1. Hi Sandra,
      Hypothyroid is when someones TSH is out of range high and T4 is out of range low – conventional ranges that is. Out of range high on TPO and/or thyroglobulin usually diagnosis Hashimoto’s. If you search these terms in our search box you will see previous posts where I elaborate :). The point when someone tips over the edge is not black/white. Hope this helps!

  2. Good information. I am curious then at what point then is it considered hypothyroidism or in fact Hashimoto’s? My husband has high TSH and and high antibodies but to date is not on medication.

    What then becomes the marker to know when he has tipped over the edge?

    1. Hi Sandra,
      Hypothyroid is when someones TSH is out of range high and T4 is out of range low – conventional ranges that is. Out of range high on TPO and/or thyroglobulin usually diagnosis Hashimoto’s. If you search these terms in our search box you will see previous posts where I elaborate :). The point when someone tips over the edge is not black/white. Hope this helps!

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