September 15, 2025 • 16 mins
That bone-deep exhaustion, creeping weight gain, and stubborn brain fog aren’t just part of getting older—they could be signs of Hashimoto’s thyroiditis, the most common autoimmune thyroid condition affecting millions worldwide.
In this episode of The Health Pulse, we explore how the immune system mistakenly attacks the thyroid gland, gradually impairing its ability to produce the hormones every cell in your body depends on. We discuss why symptoms often go overlooked or misdiagnosed, how TSH and thyroid antibody testing confirm the condition, and why women between ages 30–60 are especially vulnerable.
Beyond medication, we highlight a comprehensive care approach—covering nutrition (selenium, vitamin D, gluten sensitivity), stress management, and lifestyle interventions that support thyroid and immune health. Most importantly, we emphasize how early detection and proper testing can prevent years of diminished quality of life and long-term complications.
If you’ve been told “your labs look normal” but still don’t feel like yourself, this episode may provide the missing piece.
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Disclaimer: The information provided in this podcast is for informational purposes only and should not be considered medical advice. The content discussed is based on research, expert insights, and reputable sources, but it does not replace professional medical consultation, diagnosis, or treatment. We strive to present accurate and up-to-date information, medical research is constantly evolving. Listeners should always verify details with trusted health organizations, before making any health-related decisions. If you are experiencing a medical emergency, such as severe pain, difficulty breathing, or other urgent symptoms, call your local emergency services immediately. By listening to this podcast, you acknowledge that The Health Pulse and its creators are not responsible for any actions taken based on the content of this episode. Your health and well-being should always be guided by the advice of qualified medical professionals.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Nicolette (00:01):
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Rachel (00:25):
Have you ever felt just persistently tired like that
bone?
Deep exhaustion sleep doesn'ttouch.
Yeah, or maybe you'restruggling with weight gain, but
your habits haven't reallyshifted.
Mark (00:36):
That's a common one.
Rachel (00:38):
Right, or your brain just feels foggy sometimes and
you're left thinking what isactually going on here?
For a lot of people, thesearen't just, you know, stress or
getting older.
They might be signs ofsomething like Hashimoto's
thyroiditis.
Mark (00:51):
An autoimmune condition, yeah.
Rachel (00:52):
Exactly, and it often goes undiagnosed for ages.
So today we're doing a deepdive into this Hashimoto's it's
a really important topic.
We want to unpack what it is.
Look at the causes, thosereally sneaky symptoms that look
like other things.
Mark (01:07):
They can be very misleading.
Rachel (01:08):
And, crucially, how finding out early and using a
whole picture approach cangenuinely make a difference.
Mark (01:15):
It really can.
It's incredibly common.
Hashimoto's is but, like yousaid, often misunderstood.
And when you think about thingsthat just sort of subtly drain
your quality of life, thethyroid is often right there in
the middle.
Rachel (01:28):
That little gland right.
Mark (01:30):
Yeah, small butterfly-shaped gland, but its
job is huge Regulatingmetabolism, energy, hormones.
Rachel (01:38):
Everything, basically.
Mark (01:40):
Pretty much so.
When it's not working right,like with Hashimoto's, the
effects spread out everywhere.
Rachel (01:44):
Okay, so let's get right into it then.
What is Hashimoto's thyroiditisfundamentally?
Why is it so important for ourdeep dive?
Mark (01:52):
Okay, so at its core, Hashimoto's is an autoimmune
disease.
Rachel (01:56):
Meaning the body attacks itself.
Mark (01:57):
Exactly.
Your immune system, whichshould be protecting you, gets
confused and starts attackingyour thyroid gland Whoa, which
should be protecting you, getsconfused and starts attacking
your thyroid gland Whoa.
And it's not just a randomattack.
It's driven by specificantibodies, mostly thyroid
peroxidase antibodies TPUAB wecall them and thyroglobulin
antibodies or TGAB.
Rachel (02:14):
TPUAB and TGAB.
Mark (02:16):
Got it Right.
And these antibodies?
They gradually damage thethyroid tissue.
It's a slow process butpersistent.
Rachel (02:23):
You mentioned the thyroid's crucial role.
Can you break down just howvital it is?
What are those key hormonesdoing?
Mark (02:28):
Absolutely.
The thyroid's like a masterregulator for the whole body.
It makes two main hormonesthyroxine, that's, t4, and
treated with iron in T3.
T4 and T3.
And these hormones areessential.
I mean literally every cell inyour body needs them.
They control your metabolism,how you produce energy, body
temperature, even mood andthinking.
Rachel (02:47):
So if they're off, you really feel it.
Mark (02:49):
You feel it everywhere, yeah, so, as those antibodies
keep attacking, the thyroidstruggles to make enough T4 and
T3.
Nicolette (02:57):
Right.
Mark (02:57):
Then your pituitary gland kind of the control center in
your brain notices this andtries to compensate.
Rachel (03:03):
How does it do that?
Mark (03:04):
It starts pumping out more thyroid stimulating hormone TSH
.
It's basically yelling at thethyroid.
Work harder, make more hormones.
Rachel (03:12):
Ah, okay.
Mark (03:12):
So early on you might just see that TSH level go up, even
if T4 and T3 look normal on atest.
That's subclinicalhypothyroidism.
You have a warning sign, kindof All right.
But if the damage continues itoften progresses to overt
hypothyroidism, where thehormone levels are clearly low
and that usually needs lifelonghormone replacement therapy.
Rachel (03:32):
That makes sense.
Now, does Hashimoto's affecteveryone equally, or are certain
groups more likely to developit, like age or gender?
Mark (03:39):
That's a really good question.
There's a definite pattern.
While men and even kids can getit, it's much, much more common
in women.
Rachel (03:47):
Really.
Why is that?
Mark (03:49):
Well, the exact reasons are complex, probably linked to
hormones and maybe the Xchromosome.
But the numbers are clear,especially women between, say,
30 and 60.
Rachel (03:58):
Interesting, and does it usually show up alone or does
it tend to bring friends otherconditions?
Mark (04:04):
It often travels in packs.
Unfortunately, it's frequentlyfound alongside other autoimmune
conditions.
Rachel (04:10):
Like what.
Mark (04:11):
Things like type 1 diabetes, celiac disease,
pernicious anemia.
It really highlights that ifyour immune system is prone to
attacking one part of you, itmight target others too.
It's systemic.
Rachel (04:22):
Right that interconnectedness of autoimmune
issues.
So if the body's attackingitself, what pulls the trigger?
Is it just bad luck with genes,or do things in our environment
play a role?
Mark (04:31):
It really seems to be both A complex dance, like you said.
Okay, the research pointsstrongly towards an interaction.
You might have a geneticpredisposition Certain genes
make you more susceptible.
Rachel (04:42):
So it runs in families sometimes.
Mark (04:43):
Definitely, a strong family history of autoimmune
thyroid disease increases yourrisk significantly.
Rachel (04:50):
And the higher rate in women ties back to genetics and
hormones too.
Mark (04:54):
Likely yes.
The X chromosome link andhormonal factors are thought to
play a big role there.
Rachel (04:59):
OK, so genetics sets the stage.
What about the environmentaltriggers that might sort of
light the fuse.
Mark (05:06):
Right, this is where it gets really interesting and
sometimes counterintuitive.
Take iodine.
Rachel (05:11):
You need that for your thyroid, don't you?
Mark (05:12):
You absolutely do.
Essential for hormoneproduction.
But here's the twist Forsomeone susceptible to
Hashimoto's, too much iodine canactually fuel the autoimmune
attack.
Rachel (05:23):
Wow.
Mark (05:24):
So more isn't better Not in this case it's called the
iodine paradox.
Finding that just right balanceis critical.
It's not about zero iodine, butavoiding excess.
Rachel (05:32):
That's a really key point.
What else?
Mark (05:34):
Well, infections might play a role.
Sometimes a virus or bacteriacould trigger the immune system
and it mistakenly cross-reactswith thyroid tissue.
Chronic stress is a big one too.
We know.
Stress messes with immuneregulation and can even affect
how your body converts thyroidhormones.
Rachel (05:51):
Makes sense.
Stress affects everything.
Mark (05:53):
It really does.
And then there's radiationexposure, which has also been
linked.
So knowing these factors,especially if you have symptoms
like fatigue or mood changes youcan't explain, is important.
Rachel (06:05):
Yeah, absolutely.
That iodine paradox isfascinating.
It really challenges thatsimple.
More vitamins is good idea.
Mark (06:12):
It does.
It highlights the complexity.
Rachel (06:14):
Okay.
So moving to symptoms youmentioned, they're sneaky.
One of the biggest hurdles withHashimoto's is that the
symptoms are often vague.
They creep up slowly.
Exactly, one of the biggesthurdles with Hashimoto's is that
the symptoms are often vague,they creep up slowly.
People mistake them for juststress or, you know, getting
older.
What should we really belooking out for, those masked
signs?
Mark (06:30):
This is where it gets tricky.
In the very early stages youmight feel nothing at all.
Rachel (06:35):
Even though the attack is happening.
Mark (06:37):
Even while the antibodies are already doing their thing,
yeah, but as the thyroid'shormone production starts to
drop, the symptoms become morenoticeable.
Rachel (06:46):
Like what specifically?
Mark (06:47):
Well, fatigue is a huge one, profound fatigue, not just
needing a nap, but that deepexhaustion that doesn't go away
with rest, waking up tired.
Rachel (06:57):
I hear that a lot.
Mark (06:58):
Then there's often weight gain, Even if you haven't
changed your diet or exercisemuch.
That can be really frustratingfor people.
Rachel (07:04):
I bet.
Mark (07:04):
Feeling cold when others aren't cold intolerance we call
it.
Nicolette (07:08):
That's classic Okay.
Mark (07:09):
Also things like hair loss , really dry skin, constipation,
because digestion slows downand mood changes are common too
Depression, anxiety or that sortof mental fog, trouble
concentrating.
Rachel (07:23):
Grain fog yeah.
Mark (07:24):
And for women, irregular periods are a frequent sign.
Sometimes, if the thyroidswells up, forms a goiter, you
might get hoarseness or noticeswelling in your neck.
Rachel (07:34):
It sounds like it really impacts quality of life across
the board.
Mark (07:37):
Absolutely, it chips away at it.
Rachel (07:38):
Is there one symptom you find is most often dismissed or
overlooked, the one people justwrite off?
Mark (07:43):
I'd say the fatigue hands down.
Yeah, so many people justaccept it.
They think, oh, I'm busy or I'mjust getting older.
But the fatigue withHashimoto's is often different.
It's persistent, unrelenting.
It's not normal tiredness.
Rachel (07:58):
That's a really important distinction.
Don't just assume, fatigue isnormal.
Mark (08:01):
Exactly that lingering exhaustion could be your body
trying to tell you something.
Rachel (08:05):
Okay, but you said these symptoms are nonspecific.
They could be lots of things,right?
So how do you actually knowit's Hashimoto's and not
something else?
Mark (08:14):
And that brings us straight to the crucial point
lab testing.
It is absolutely essential.
Rachel (08:19):
No guessing.
Mark (08:20):
No guessing.
It's the only way to get aclear diagnosis and understand
what's truly going on with thethyroid and the immune system.
Rachel (08:27):
Okay, so let's say someone gets that diagnosis
through testing.
What happens next?
What's the management plan looklike?
Is it just taking a pill?
Mark (08:36):
Well, medication is definitely the cornerstone of
treatment.
Rachel (08:38):
Okay.
Mark (08:39):
Thyroid hormone replacement, usually with
levothyroxine, that's, syntheticT4, is the standard approach.
The American ThyroidAssociation considers it the
gold standard.
Rachel (08:49):
And what does that medication do?
Mark (08:50):
Its main job is to bring your thyroid hormone levels back
into the normal range.
This helps relieve thosesymptoms of hypothyroidism and
prevents long-term problems.
Rachel (09:00):
And you monitor levels with tests.
Mark (09:02):
Constantly Well.
Regularly, PSH is the mainmarker we track to make sure the
dose is right for you.
It often needs adjusting overtime.
Rachel (09:09):
Now I have heard some people say they still don't feel
quite right, even when theirTSH looks good, on levothyroxine
alone.
What about using both T4 and T3, that combination therapy?
Mark (09:21):
That's a really relevant question and it's an area where
there's still some debate.
Nicolette (09:25):
Oh.
Mark (09:26):
Yes, some individuals report feeling better when they
add lyotheranine, which is T3,to their levothyroxine.
For certain carefully chosenpatients, it might be considered
.
But, it's not for everyone.
No, definitely not a first-lineapproach for everyone.
The research results are mixedand current guidelines suggest
using it cautiously.
It can help some, but T4 aloneworks well for most.
Rachel (09:46):
Got it so, beyond medication side, our sources
really emphasize lifestyle andnutrition.
How much impact do those have?
Mark (09:53):
A significant impact.
Think of medication ascorrecting the hormone levels
but lifestyle factors helpmanage the underlying autoimmune
process and improve overallwell-being.
Rachel (10:05):
Building that supportive ecosystem, like you said
earlier.
Mark (10:08):
Exactly, we talked about iodine balance Not too much, not
too little.
That's key.
Rachel (10:11):
Right the paradox.
Mark (10:12):
Then there are nutrients like selenium.
It helps with thyroid hormonemetabolism and some studies
suggest it might even lowerthose antibody levels and
vitamin D.
So many people with autoimmuneconditions are deficient and
getting levels up might helpwith immune regulation.
Rachel (10:28):
Okay, what about diet?
I hear a lot about gluten.
Mark (10:32):
Yes, the gluten connection comes up often.
There's a known link,especially with celiac disease,
which is also autoimmune.
Rachel (10:38):
Right.
Mark (10:38):
Some people with Hashimoto's, even without celiac
, report feeling bettersymptom-wise when they go
gluten-free.
The evidence is still evolving.
It's not a universalrecommendation, but it's
something individuals mightexplore with their doctor.
Rachel (10:53):
Makes sense to consider individually.
Mark (10:55):
Absolutely.
And then don't underestimatestress management and lifestyle.
Chronic stress really disruptsthat whole brain.
Thyroid communication pathway.
Rachel (11:03):
The HPA axis or HP2 axis .
Mark (11:06):
The HPT hypothalamic pituitary thyroid axis.
Yes, Stress throws it offbalance and fuels immune issues.
So things like getting enoughsleep, finding ways to manage
stress, mindfulness, yogawhatever works for you and
balanced exercise are reallyfundamental.
Rachel (11:22):
So it's not just about popping a pill, it's about this
whole integrated approach.
Mark (11:26):
That's the goal for optimal well-being.
Rachel (11:27):
But it's important to stress right that these
lifestyle things supporttreatment.
They don't replace it.
No diet cures Hashimoto's.
Mark (11:34):
That's a critical clarification, thank you.
These strategies work bestalongside appropriate medical
care, including hormonereplacement if needed.
They empower you to feel betterwithin the context of managing
a chronic condition.
Rachel (11:45):
And are there any newer things on the horizon?
You mentioned emerging research.
Mark (11:49):
Yeah, it's an active area.
We're seeing some intriguing,though preliminary reports on
ketogenic or low-carb dietspotentially impacting antibody
levels.
More research is definitelyneeded there, and the whole
field of the gut microbiome isexploding.
Understanding how gut healthinfluences autoimmune conditions
like Hashimoto's could open upentirely new therapeutic avenues
in the future.
(12:10):
It's really promising.
Rachel (12:11):
Very cool.
So back to the testing then.
Since symptoms overlap so much,lab tests are the definitive
tool.
Mark (12:18):
Absolutely.
They're your map, essential fordiagnosis, essential for
tracking progress, essential forguiding treatment adjustments.
Rachel (12:25):
Can't manage it effectively without them.
Mark (12:27):
You really can't.
You'd just be flying blind.
Rachel (12:29):
Okay, so let's quickly run through the key tests again.
What are we looking for inthose results?
Mark (12:33):
Sure, first up is TSH thyroid-stimulating hormone
often the first thing to go outof range when the thyroid starts
struggling.
Rachel (12:41):
The pituitary shouting louder.
Mark (12:43):
Exactly, then you need to know the actual hormone levels,
free T4 and free T3.
These show how much activehormone is available to your
cells.
Then, crucially for Hashimoto's, the antibodies TPO-AB, thyroid
peroxidase antibodies and TGABtheroglobulin antibodies.
High levels confirm thatautoimmune attack on the thyroid
(13:04):
.
Rachel (13:04):
The smoking gun basically.
Mark (13:06):
Pretty much.
Sometimes doctors might look atreverse T3, which can give
clues about how well your bodyis converting T4 into the active
T3 form.
Rachel (13:16):
Right.
Mark (13:17):
And finally, checking those nutritional cofactors.
We mentioned vitamin D,selenium, maybe iron and B12,
because deficiencies are commonand can worsen symptoms.
Rachel (13:26):
That's a comprehensive panel.
Mark (13:28):
It gives a much fuller picture.
Rachel (13:29):
And the good news is, getting these tests done is
easier than ever now right, moreconvenient options.
Mark (13:35):
Definitely.
Advances in testing mean it'soften more accessible, sometimes
with convenient samplecollection and results delivered
securely to you and your doctor.
It puts more power in yourhands.
Rachel (13:44):
And the real benefit here is catching it early.
Mark (13:46):
That's the key takeaway Early accurate testing can
literally save you years offeeling unwell, years of
confusion, years of missedchances to intervene and feel
better sooner.
Rachel (13:57):
Yeah, all that time and energy wasted just wondering
what's wrong.
Mark (14:00):
Precisely Getting that clear diagnosis and a
personalized plan istransformative.
Rachel (14:05):
So, wrapping up our deep dive, today we've really
explored Hashimoto's thyroiditis.
It's the most common reason forhypothyroidism in places like
the US.
And it's this complex mix,isn't it?
Genetics, environment,lifestyle all interacting and
often hiding right under ournoses.
Mark (14:22):
It truly is and it impacts how you feel, think and
function every single day.
Rachel (14:27):
And while that standard treatment levothyroxine is
crucial.
Mark (14:30):
It absolutely is.
Rachel (14:31):
It's also clear that paying attention to nutrition,
managing stress, staying active,maybe exploring some of those
dietary approaches these thingsreally add up.
They play a huge supportiverole in quality of life.
Mark (14:43):
They empower the patient, giving them tools beyond just
medication.
Rachel (14:47):
Absolutely.
But the single most importantfirst step, the thing that
really gives you control,testing, early and accurate
testing, knowing your numbers,tsh free, hormones and
especially those antibodies yes,that allows you and your doctor
to step in much sooner.
It's not just about symptomrelief.
It's about preventing years offatigue, weight struggles, brain
fog, all those things thatdiminish your life.
Mark (15:09):
It's about reclaiming your health and vitality,
understanding those subtlesignals your body sends and then
being proactive, asking for theright tests.
That could be the key, Evenwhen symptoms seem vague.
Rachel (15:21):
Yeah.
Mark (15:21):
So maybe the final thought for everyone listening is this
what other common symptoms mightyou be experiencing, things
you've maybe brushed off?
Could they be pointing tosomething deeper, something like
Hashimoto's that you haven'texplored yet?
Nicolette (15:40):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit For
more health insights anddiagnostics.
Subscribe and share it withsomeone who might benefit For
more health insights anddiagnostics.
Visit us online atwwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Rachel (00:25):
Have you ever felt just persistently tired like that
bone?
Deep exhaustion sleep doesn'ttouch.
Yeah, or maybe you'restruggling with weight gain, but
your habits haven't reallyshifted.
Mark (00:36):
That's a common one.
Rachel (00:38):
Right, or your brain just feels foggy sometimes and
you're left thinking what isactually going on here?
For a lot of people, thesearen't just, you know, stress or
getting older.
They might be signs ofsomething like Hashimoto's
thyroiditis.
Mark (00:51):
An autoimmune condition, yeah.
Rachel (00:52):
Exactly, and it often goes undiagnosed for ages.
So today we're doing a deepdive into this Hashimoto's it's
a really important topic.
We want to unpack what it is.
Look at the causes, thosereally sneaky symptoms that look
like other things.
Mark (01:07):
They can be very misleading.
Rachel (01:08):
And, crucially, how finding out early and using a
whole picture approach cangenuinely make a difference.
Mark (01:15):
It really can.
It's incredibly common.
Hashimoto's is but, like yousaid, often misunderstood.
And when you think about thingsthat just sort of subtly drain
your quality of life, thethyroid is often right there in
the middle.
Rachel (01:28):
That little gland right.
Mark (01:30):
Yeah, small butterfly-shaped gland, but its
job is huge Regulatingmetabolism, energy, hormones.
Rachel (01:38):
Everything, basically.
Mark (01:40):
Pretty much so.
When it's not working right,like with Hashimoto's, the
effects spread out everywhere.
Rachel (01:44):
Okay, so let's get right into it then.
What is Hashimoto's thyroiditisfundamentally?
Why is it so important for ourdeep dive?
Mark (01:52):
Okay, so at its core, Hashimoto's is an autoimmune
disease.
Rachel (01:56):
Meaning the body attacks itself.
Mark (01:57):
Exactly.
Your immune system, whichshould be protecting you, gets
confused and starts attackingyour thyroid gland Whoa, which
should be protecting you, getsconfused and starts attacking
your thyroid gland Whoa.
And it's not just a randomattack.
It's driven by specificantibodies, mostly thyroid
peroxidase antibodies TPUAB wecall them and thyroglobulin
antibodies or TGAB.
Rachel (02:14):
TPUAB and TGAB.
Mark (02:16):
Got it Right.
And these antibodies?
They gradually damage thethyroid tissue.
It's a slow process butpersistent.
Rachel (02:23):
You mentioned the thyroid's crucial role.
Can you break down just howvital it is?
What are those key hormonesdoing?
Mark (02:28):
Absolutely.
The thyroid's like a masterregulator for the whole body.
It makes two main hormonesthyroxine, that's, t4, and
treated with iron in T3.
T4 and T3.
And these hormones areessential.
I mean literally every cell inyour body needs them.
They control your metabolism,how you produce energy, body
temperature, even mood andthinking.
Rachel (02:47):
So if they're off, you really feel it.
Mark (02:49):
You feel it everywhere, yeah, so, as those antibodies
keep attacking, the thyroidstruggles to make enough T4 and
T3.
Nicolette (02:57):
Right.
Mark (02:57):
Then your pituitary gland kind of the control center in
your brain notices this andtries to compensate.
Rachel (03:03):
How does it do that?
Mark (03:04):
It starts pumping out more thyroid stimulating hormone TSH
.
It's basically yelling at thethyroid.
Work harder, make more hormones.
Rachel (03:12):
Ah, okay.
Mark (03:12):
So early on you might just see that TSH level go up, even
if T4 and T3 look normal on atest.
That's subclinicalhypothyroidism.
You have a warning sign, kindof All right.
But if the damage continues itoften progresses to overt
hypothyroidism, where thehormone levels are clearly low
and that usually needs lifelonghormone replacement therapy.
Rachel (03:32):
That makes sense.
Now, does Hashimoto's affecteveryone equally, or are certain
groups more likely to developit, like age or gender?
Mark (03:39):
That's a really good question.
There's a definite pattern.
While men and even kids can getit, it's much, much more common
in women.
Rachel (03:47):
Really.
Why is that?
Mark (03:49):
Well, the exact reasons are complex, probably linked to
hormones and maybe the Xchromosome.
But the numbers are clear,especially women between, say,
30 and 60.
Rachel (03:58):
Interesting, and does it usually show up alone or does
it tend to bring friends otherconditions?
Mark (04:04):
It often travels in packs.
Unfortunately, it's frequentlyfound alongside other autoimmune
conditions.
Rachel (04:10):
Like what.
Mark (04:11):
Things like type 1 diabetes, celiac disease,
pernicious anemia.
It really highlights that ifyour immune system is prone to
attacking one part of you, itmight target others too.
It's systemic.
Rachel (04:22):
Right that interconnectedness of autoimmune
issues.
So if the body's attackingitself, what pulls the trigger?
Is it just bad luck with genes,or do things in our environment
play a role?
Mark (04:31):
It really seems to be both A complex dance, like you said.
Okay, the research pointsstrongly towards an interaction.
You might have a geneticpredisposition Certain genes
make you more susceptible.
Rachel (04:42):
So it runs in families sometimes.
Mark (04:43):
Definitely, a strong family history of autoimmune
thyroid disease increases yourrisk significantly.
Rachel (04:50):
And the higher rate in women ties back to genetics and
hormones too.
Mark (04:54):
Likely yes.
The X chromosome link andhormonal factors are thought to
play a big role there.
Rachel (04:59):
OK, so genetics sets the stage.
What about the environmentaltriggers that might sort of
light the fuse.
Mark (05:06):
Right, this is where it gets really interesting and
sometimes counterintuitive.
Take iodine.
Rachel (05:11):
You need that for your thyroid, don't you?
Mark (05:12):
You absolutely do.
Essential for hormoneproduction.
But here's the twist Forsomeone susceptible to
Hashimoto's, too much iodine canactually fuel the autoimmune
attack.
Rachel (05:23):
Wow.
Mark (05:24):
So more isn't better Not in this case it's called the
iodine paradox.
Finding that just right balanceis critical.
It's not about zero iodine, butavoiding excess.
Rachel (05:32):
That's a really key point.
What else?
Mark (05:34):
Well, infections might play a role.
Sometimes a virus or bacteriacould trigger the immune system
and it mistakenly cross-reactswith thyroid tissue.
Chronic stress is a big one too.
We know.
Stress messes with immuneregulation and can even affect
how your body converts thyroidhormones.
Rachel (05:51):
Makes sense.
Stress affects everything.
Mark (05:53):
It really does.
And then there's radiationexposure, which has also been
linked.
So knowing these factors,especially if you have symptoms
like fatigue or mood changes youcan't explain, is important.
Rachel (06:05):
Yeah, absolutely.
That iodine paradox isfascinating.
It really challenges thatsimple.
More vitamins is good idea.
Mark (06:12):
It does.
It highlights the complexity.
Rachel (06:14):
Okay.
So moving to symptoms youmentioned, they're sneaky.
One of the biggest hurdles withHashimoto's is that the
symptoms are often vague.
They creep up slowly.
Exactly, one of the biggesthurdles with Hashimoto's is that
the symptoms are often vague,they creep up slowly.
People mistake them for juststress or, you know, getting
older.
What should we really belooking out for, those masked
signs?
Mark (06:30):
This is where it gets tricky.
In the very early stages youmight feel nothing at all.
Rachel (06:35):
Even though the attack is happening.
Mark (06:37):
Even while the antibodies are already doing their thing,
yeah, but as the thyroid'shormone production starts to
drop, the symptoms become morenoticeable.
Rachel (06:46):
Like what specifically?
Mark (06:47):
Well, fatigue is a huge one, profound fatigue, not just
needing a nap, but that deepexhaustion that doesn't go away
with rest, waking up tired.
Rachel (06:57):
I hear that a lot.
Mark (06:58):
Then there's often weight gain, Even if you haven't
changed your diet or exercisemuch.
That can be really frustratingfor people.
Rachel (07:04):
I bet.
Mark (07:04):
Feeling cold when others aren't cold intolerance we call
it.
Nicolette (07:08):
That's classic Okay.
Mark (07:09):
Also things like hair loss , really dry skin, constipation,
because digestion slows downand mood changes are common too
Depression, anxiety or that sortof mental fog, trouble
concentrating.
Rachel (07:23):
Grain fog yeah.
Mark (07:24):
And for women, irregular periods are a frequent sign.
Sometimes, if the thyroidswells up, forms a goiter, you
might get hoarseness or noticeswelling in your neck.
Rachel (07:34):
It sounds like it really impacts quality of life across
the board.
Mark (07:37):
Absolutely, it chips away at it.
Rachel (07:38):
Is there one symptom you find is most often dismissed or
overlooked, the one people justwrite off?
Mark (07:43):
I'd say the fatigue hands down.
Yeah, so many people justaccept it.
They think, oh, I'm busy or I'mjust getting older.
But the fatigue withHashimoto's is often different.
It's persistent, unrelenting.
It's not normal tiredness.
Rachel (07:58):
That's a really important distinction.
Don't just assume, fatigue isnormal.
Mark (08:01):
Exactly that lingering exhaustion could be your body
trying to tell you something.
Rachel (08:05):
Okay, but you said these symptoms are nonspecific.
They could be lots of things,right?
So how do you actually knowit's Hashimoto's and not
something else?
Mark (08:14):
And that brings us straight to the crucial point
lab testing.
It is absolutely essential.
Rachel (08:19):
No guessing.
Mark (08:20):
No guessing.
It's the only way to get aclear diagnosis and understand
what's truly going on with thethyroid and the immune system.
Rachel (08:27):
Okay, so let's say someone gets that diagnosis
through testing.
What happens next?
What's the management plan looklike?
Is it just taking a pill?
Mark (08:36):
Well, medication is definitely the cornerstone of
treatment.
Rachel (08:38):
Okay.
Mark (08:39):
Thyroid hormone replacement, usually with
levothyroxine, that's, syntheticT4, is the standard approach.
The American ThyroidAssociation considers it the
gold standard.
Rachel (08:49):
And what does that medication do?
Mark (08:50):
Its main job is to bring your thyroid hormone levels back
into the normal range.
This helps relieve thosesymptoms of hypothyroidism and
prevents long-term problems.
Rachel (09:00):
And you monitor levels with tests.
Mark (09:02):
Constantly Well.
Regularly, PSH is the mainmarker we track to make sure the
dose is right for you.
It often needs adjusting overtime.
Rachel (09:09):
Now I have heard some people say they still don't feel
quite right, even when theirTSH looks good, on levothyroxine
alone.
What about using both T4 and T3, that combination therapy?
Mark (09:21):
That's a really relevant question and it's an area where
there's still some debate.
Nicolette (09:25):
Oh.
Mark (09:26):
Yes, some individuals report feeling better when they
add lyotheranine, which is T3,to their levothyroxine.
For certain carefully chosenpatients, it might be considered
.
But, it's not for everyone.
No, definitely not a first-lineapproach for everyone.
The research results are mixedand current guidelines suggest
using it cautiously.
It can help some, but T4 aloneworks well for most.
Rachel (09:46):
Got it so, beyond medication side, our sources
really emphasize lifestyle andnutrition.
How much impact do those have?
Mark (09:53):
A significant impact.
Think of medication ascorrecting the hormone levels
but lifestyle factors helpmanage the underlying autoimmune
process and improve overallwell-being.
Rachel (10:05):
Building that supportive ecosystem, like you said
earlier.
Mark (10:08):
Exactly, we talked about iodine balance Not too much, not
too little.
That's key.
Rachel (10:11):
Right the paradox.
Mark (10:12):
Then there are nutrients like selenium.
It helps with thyroid hormonemetabolism and some studies
suggest it might even lowerthose antibody levels and
vitamin D.
So many people with autoimmuneconditions are deficient and
getting levels up might helpwith immune regulation.
Rachel (10:28):
Okay, what about diet?
I hear a lot about gluten.
Mark (10:32):
Yes, the gluten connection comes up often.
There's a known link,especially with celiac disease,
which is also autoimmune.
Rachel (10:38):
Right.
Mark (10:38):
Some people with Hashimoto's, even without celiac
, report feeling bettersymptom-wise when they go
gluten-free.
The evidence is still evolving.
It's not a universalrecommendation, but it's
something individuals mightexplore with their doctor.
Rachel (10:53):
Makes sense to consider individually.
Mark (10:55):
Absolutely.
And then don't underestimatestress management and lifestyle.
Chronic stress really disruptsthat whole brain.
Thyroid communication pathway.
Rachel (11:03):
The HPA axis or HP2 axis .
Mark (11:06):
The HPT hypothalamic pituitary thyroid axis.
Yes, Stress throws it offbalance and fuels immune issues.
So things like getting enoughsleep, finding ways to manage
stress, mindfulness, yogawhatever works for you and
balanced exercise are reallyfundamental.
Rachel (11:22):
So it's not just about popping a pill, it's about this
whole integrated approach.
Mark (11:26):
That's the goal for optimal well-being.
Rachel (11:27):
But it's important to stress right that these
lifestyle things supporttreatment.
They don't replace it.
No diet cures Hashimoto's.
Mark (11:34):
That's a critical clarification, thank you.
These strategies work bestalongside appropriate medical
care, including hormonereplacement if needed.
They empower you to feel betterwithin the context of managing
a chronic condition.
Rachel (11:45):
And are there any newer things on the horizon?
You mentioned emerging research.
Mark (11:49):
Yeah, it's an active area.
We're seeing some intriguing,though preliminary reports on
ketogenic or low-carb dietspotentially impacting antibody
levels.
More research is definitelyneeded there, and the whole
field of the gut microbiome isexploding.
Understanding how gut healthinfluences autoimmune conditions
like Hashimoto's could open upentirely new therapeutic avenues
in the future.
(12:10):
It's really promising.
Rachel (12:11):
Very cool.
So back to the testing then.
Since symptoms overlap so much,lab tests are the definitive
tool.
Mark (12:18):
Absolutely.
They're your map, essential fordiagnosis, essential for
tracking progress, essential forguiding treatment adjustments.
Rachel (12:25):
Can't manage it effectively without them.
Mark (12:27):
You really can't.
You'd just be flying blind.
Rachel (12:29):
Okay, so let's quickly run through the key tests again.
What are we looking for inthose results?
Mark (12:33):
Sure, first up is TSH thyroid-stimulating hormone
often the first thing to go outof range when the thyroid starts
struggling.
Rachel (12:41):
The pituitary shouting louder.
Mark (12:43):
Exactly, then you need to know the actual hormone levels,
free T4 and free T3.
These show how much activehormone is available to your
cells.
Then, crucially for Hashimoto's, the antibodies TPO-AB, thyroid
peroxidase antibodies and TGABtheroglobulin antibodies.
High levels confirm thatautoimmune attack on the thyroid
(13:04):
.
Rachel (13:04):
The smoking gun basically.
Mark (13:06):
Pretty much.
Sometimes doctors might look atreverse T3, which can give
clues about how well your bodyis converting T4 into the active
T3 form.
Rachel (13:16):
Right.
Mark (13:17):
And finally, checking those nutritional cofactors.
We mentioned vitamin D,selenium, maybe iron and B12,
because deficiencies are commonand can worsen symptoms.
Rachel (13:26):
That's a comprehensive panel.
Mark (13:28):
It gives a much fuller picture.
Rachel (13:29):
And the good news is, getting these tests done is
easier than ever now right, moreconvenient options.
Mark (13:35):
Definitely.
Advances in testing mean it'soften more accessible, sometimes
with convenient samplecollection and results delivered
securely to you and your doctor.
It puts more power in yourhands.
Rachel (13:44):
And the real benefit here is catching it early.
Mark (13:46):
That's the key takeaway Early accurate testing can
literally save you years offeeling unwell, years of
confusion, years of missedchances to intervene and feel
better sooner.
Rachel (13:57):
Yeah, all that time and energy wasted just wondering
what's wrong.
Mark (14:00):
Precisely Getting that clear diagnosis and a
personalized plan istransformative.
Rachel (14:05):
So, wrapping up our deep dive, today we've really
explored Hashimoto's thyroiditis.
It's the most common reason forhypothyroidism in places like
the US.
And it's this complex mix,isn't it?
Genetics, environment,lifestyle all interacting and
often hiding right under ournoses.
Mark (14:22):
It truly is and it impacts how you feel, think and
function every single day.
Rachel (14:27):
And while that standard treatment levothyroxine is
crucial.
Mark (14:30):
It absolutely is.
Rachel (14:31):
It's also clear that paying attention to nutrition,
managing stress, staying active,maybe exploring some of those
dietary approaches these thingsreally add up.
They play a huge supportiverole in quality of life.
Mark (14:43):
They empower the patient, giving them tools beyond just
medication.
Rachel (14:47):
Absolutely.
But the single most importantfirst step, the thing that
really gives you control,testing, early and accurate
testing, knowing your numbers,tsh free, hormones and
especially those antibodies yes,that allows you and your doctor
to step in much sooner.
It's not just about symptomrelief.
It's about preventing years offatigue, weight struggles, brain
fog, all those things thatdiminish your life.
Mark (15:09):
It's about reclaiming your health and vitality,
understanding those subtlesignals your body sends and then
being proactive, asking for theright tests.
That could be the key, Evenwhen symptoms seem vague.
Rachel (15:21):
Yeah.
Mark (15:21):
So maybe the final thought for everyone listening is this
what other common symptoms mightyou be experiencing, things
you've maybe brushed off?
Could they be pointing tosomething deeper, something like
Hashimoto's that you haven'texplored yet?
Nicolette (15:40):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit For
more health insights anddiagnostics.
Subscribe and share it withsomeone who might benefit For
more health insights anddiagnostics.
Visit us online atwwwquicklabmobilecom.
Stay informed, stay healthy andwe'll catch you in the next
episode.
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