6 Common Daily Challenges Patients With Hashimoto’s Thyroiditis Face

Many patients with Hashimoto’s thyroiditis often have deficiencies of which they are unaware. Targeted lab tests identify these micronutrient deficiencies and metabolic disorders that worsen the health and quality of life of these patients.

Hashimoto’s thyroiditis is one of the most common autoimmune diseases, significantly impacting the daily lives of millions worldwide.

It primarily affects women (at a ratio of 9 to 1 compared with men), due to their distinct metabolic profile and the multiple hormonal changes that occur throughout life ^[1].

In autoimmune diseases, the immune system fails to recognize the body’s own tissues and attacks them. In Hashimoto’s disease, the affected organ is the thyroid gland.

The gradual destruction of the gland by the immune system, usually over years, ultimately leads to hypothyroidism.

The difficulty in treating the disease lies in the fact that it results from concurrent deficiencies and metabolic disorders that act together to cause its manifestation.

During the course of the disease and before the onset of hypothyroidism, the metabolic disturbances and deficiencies that lead to Hashimoto’s manifest as symptoms that significantly impact daily life.

Based on our clinical experience, some of the most common symptoms impacting daily life in patients with Hashimoto’s disease include:

1. Fatigue & Low Energy

The thyroid gland plays a central role in regulating the cycle of energy, fatigue, and rest.

Under normal conditions, energy peaks in the morning and gradually declines through the day. By evening, a normal level of fatigue leads to rest, restoration of strength, and repair of any damage incurred during the day.

However, the body often does not operate under ideal conditions. Underlying deficiencies in essential nutrients impair body’s performance and trigger the production of hormones such as cortisol and adrenaline to compensate.

If these deficiencies are left unaddressed, the endocrine system becomes deregulated, and patients experience repeated cycles of overexertion and exhaustion rather than the normal daily rhythm of energy and rest.

Disruption of the normal energy–rest cycle is accompanied by disruption of thyroid function, fueling a vicious cycle of gradual deterioration of overall hormonal status and the individual’s ability to cope with everyday life ^[2].

2. Weight Gain

Insulin resistance is one of the primary metabolic disorders leading to thyroid dysfunction and the development of Hashimoto’s disease.

Long before hypothyroidism occurs, insulin resistance causes metabolic disturbances and drives the accumulation of visceral abdominal fat.

Additional disorders and deficiencies associated with the disease—particularly involving vitamin D, the intestinal microbiome, zinc, magnesium, chromium, and selenium – further worsen the metabolic state and adversely affect body weight. These deficiencies often precede the development of autoimmunity and are directly linked to the onset and course of Hashimoto’s thyroiditis.

A common factor that further complicates weight control is deregulation of satiety. The hormonal and metabolic disturbances associated with the disease lead to loss of satiety signals, leaving individuals feeling unsatisfied and persistently hungry.

Consequently, even with hypothyroidism medically regulated, many people do not manage to return to a normal body weight, despite sincere efforts.

3. Gastrointestinal Disorders

Most patients with Hashimoto’s thyroiditis experience gastrointestinal disorders.

Gastrointestinal symptoms result from alterations in the intestinal microbiome and disturbances in gastrointestinal motility.

The microbiome plays a central role in digestive function and also influences numerous metabolic processes, including nutrient absorption and regulation of the immune and nervous systems.Moreover, alterations of the microbial flora are a key factor in the development and progression of autoimmune diseases ^[3].

The most common gastrointestinal symptoms include slow digestion, constipation, abdominal distension, and gallbladder-related symptoms, including gallstones. Patients often attempt to correct these symptoms by changing their diet, usually without success.

4. Mood Swings

Hypothyroidism, metabolic disorders and deficiencies common in patients with Hashimoto's disease impact the nervous and hormonal systems, leading to a significant adverse impact on their mood.

One of the most common symptoms accompanying Hashimoto’s disease is mood disturbance. Patients may experience low mood and sadness that are often disproportionate to daily circumstances.

Poor mood can alternate with intense irritability linked to the continuous lack of energy, affecting personal relationships and social interactions. Libido and sexual function are also often negatively affected in both men and women.

5. Memory Loss & Reduced Mental Clarity

The thyroid regulates, among other systems, the function of the nervous system. Additionally, disturbances in the microbiome, metabolic disorders, and deficiencies associated with Hashimoto's disease adversely affect mental functions ^[5,6].

Patients with Hashimoto’s disease often report reduced mental clarity and impaired concentration. They also report that diminished mental clarity significantly impairs work performance and social interactions.

6. Joint Pain and Muscle Cramps

Joint pain and muscle cramps are particularly common in people with Hashimoto’s disease.

Hypothyroidism, insulin resistance, and deficiencies in vitamins, minerals, and anti-inflammatory micronutrients impair the body's healing processes in patients with Hashimoto's disease, leading to chronic inflammation.

Hashimoto's Disease & Daily Life

• Fatigue and low energy
• Weight gain
• Gastrointestinal disorders
• Mood swings
• Memory loss and reduced mental clarity
• Joint pain and muscle cramps

These symptoms significantly affect the daily lives of people with Hashimoto’s disease. Patients often gradually “get used to” them and stop noticing, treating this as the “normal” course of life.Hashimoto’s thyroiditis is driven by multiple factors and often takes years or even decades to manifest.

For effective management of Hashimoto’s thyroiditis – and improvement in energy, body weight, mood, mental clarity, gastrointestinal function, and muscle pain – regulating thyroid-stimulating hormone (TSH) levels alone is not sufficient. All contributing factors that lead to its manifestation and influence its course must be identified and addressed.

Accurate detection of individual deficiencies is difficult with routine checkups, and until recently recommendations relied on broad, population-level guidelines. With targeted lab testing, we can now precisely identify each person’s deficiencies and metabolic disorders and develop personalized care plans to address them, with continuous medical monitoring by their primary care provider.

Micronutrient deficiencies develop gradually and contribute to disease over time, so correcting them requires patience and consistency.

If these deficiencies and metabolic disorders are left unaddressed, Hashimoto’s typically follows a pattern of gradual decline with alternating periods of flare-ups and remission, placing increasing strain on daily life and overall health.

Why Do Patients With Hashimoto's Often Continue to Feel Unwell, Even While Under Treatment and With Normal Test Results?

It's noteworthy that symptoms can remain, to a lesser or greater extent, even after the regulation of hypothyroidism with medication.

An individual can have normal levels of thyroid hormones and TSH, yet still exhibit most of the symptoms mentioned above.

At this point, the external administration of hormones is a vital tool to improve the patient's clinical condition and quality of life. However, the adjustment made in the medication 2-3 times during the year cannot mimic the continuous and precise regulation that the human body does, with responses occurring in seconds ^[7,8].

In our clinical experience, even with up to 80% loss of thyroid function, appropriate hormone replacement restores normal physiology without reducing quality of life. The remaining 20% of endogenous function supports routine metabolic adjustments in daily life, enabling excellent quality of life.

Therefore, preserving the thyroid’s remaining function is essential, as it helps the body maintain normal metabolic adaptation.

To achieve meaningful health improvement in Hashimoto’s patients, care must extend beyond thyroid hormone regulation to also identify and address underlying deficiencies and metabolic disorders ^[9–14].

Targeted Lab Testing to Detect Deficiencies and Metabolic Dysfunctions Related to Hashimoto’s Thyroiditis

Identifying and correcting metabolic dysfunction requires comprehensive lab testing that profiles metabolic status, inflammation, and micronutrient levels. These tests reveal the factors driving the development and expression of Hashimoto’s thyroiditis. An individual’s metabolic state is the leading risk factor for disease onset ^[13–15].

Many of these tests are uncommon in standard healthcare. Advanced panels are needed to accurately detect deficiencies and metabolic disorders in people with chronic conditions like Hashimoto’s.

This type of analysis is not comparable to routine checkups. These are highly specialised and far more comprehensive tests, usually performed only in select private clinics at very high prices. Kyma is among the few companies nationwide that offer this level of comprehensive, advanced lab testing by partnering with leading, certified partner labs such as Randox Health.

Key Factors Identified by Kyma’s Comprehensive Lab Testing

Kyma’s comprehensive lab panel detects metabolic disorders that promote the development of Hashimoto's disease, including ^[16-21]:

• Micronutrient Deficiencies: Lack of vitamin D, vitamin C, selenium, zinc, antioxidants, and omega-3s are linked to impaired immune system function, inflammation, and the health status of patients with Hashimoto's.
• Difficulty in Metabolising Simple Sugars: Excessive consumption of simple sugars beyond what the body can metabolise triggers inflammation and is a significant indicator of the disease's progression.
• Insulin Resistance: Elevated insulin levels disrupt immune system function, worsen autoimmunity, and accelerate gland destruction.
• Fatty Acid Metabolism: The ratio between omega-3 and omega-6 fatty acids is a crucial indicator of the body's ability to manage inflammation and regulate the immune system's normal response.
• State of the Microbiome: Alteration of the microbiome is linked to impaired immune system function and the ability to distinguish between its own tissues and external elements, such as pathogens and viruses.
• Thyroid Antibodies: Elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies reflect autoimmune activity and correlate with disease severity and progression risk.

Modern management of Hashimoto’s disease focuses on the restoration of the above factors, using medical interventions in lifestyle and nutrition with the aim of correcting deficiencies, in order to maintain the optimal metabolic state of the body.

In our clinical experience, this root-cause approach can lead to several benefits:

• Improved management of the disease, protecting the thyroid gland from further damage.
• Better functioning of the remaining thyroid gland, helping the body adjust its metabolism to daily needs and enhancing life quality.
• A gradual decrease in autoantibody levels.
• Reduction in fatigue and a boost in energy levels.
• Enhanced mood and fewer severe emotional fluctuations due to improved gland function.
• Lowered risk of harm to other organs and less chance of developing additional autoimmune diseases.
• Increase in metabolic rate and maintenance of a healthy body weight.
• Better response to medications.

It usually takes 6–8 months to achieve significant change, one year to stabilise the body at a better functional level, and about two years for optimal results.

As dysfunctions and deficiencies are corrected, the body reactivates regular metabolic processes and develops different needs. As care begins, changes occur in multiple metabolic pathways simultaneously. These changes must be identified and appropriately managed to continue the restoration process. Otherwise, the body’s restoration processes do not progress, significantly delaying health improvement.

Through our clinical experience, we have found that correcting the body’s deficiencies in vitamins and other elements, restoring metabolism, and regulating weight to normal levels can radically change the course of Hashimoto’s disease for the better and improve patients’ quality of life, shifting from steady worsening to steady improvement.

Promptly addressing the above issues is critical to halting the progression of the disease.

References

1. _{Hashimoto Thyroiditis. Stephanie L Lee. Medscape Mar 25, 2020}
2. _{Interconnection between circadian clocks and thyroid function Keisuke Ikegam et al. Nature Reviews Endocrinol . 2019 Oct.}
3. _{Gut microbiota and Hashimoto's thyroiditis. Camilla Virili et al. Rev Endocr Metab Disord . 2018 Dec.}
4. _{Thyroid hormones, T3 and T4, in the brain. Amy C. Schroeder and Martin L. Privalsky. Front. Endocrinol., 31 March 2014}
5. _{Dementia due to metabolic causes. Medline Plus. Accessed 2 Oct 2021.}
6. _{Cognitive and Affective Dysfunctions in Autoimmune Thyroiditis Thomas Leyhe, Karsten Müssig. Brain Behav Immun . 2014}
7. _{Thyroid Hormone Regulation of Metabolism Rashmi Mullur, Yan-Yun Liu, and Gregory A. Brent. Physiol Rev. 2014 Apr.}
8. _{Impact of stress on metabolism and energy balance. Cristina Rabasa, Suzanne L Dickson. Current Opinion in Behavioral Sciences. 2016.}
9. _{Correlation Between Hashimoto's Thyroiditis-Related Thyroid Hormone Levels and 25-Hydroxyvitamin D Guanqun Chao, Yue Zhu, Lizheng Fang. Front Endocrinol (Lausanne). 2020 Feb. https://pubmed.ncbi.nlm.nih.gov/32117049/}
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11. _{Improving the Vitamin D Status of Vitamin D Deficient Adults Is Associated With Improved Mitochondrial Oxidative Function in Skeletal Muscle Akash Sinha et. al. J Clin Endocrinol Metab . 2013. https://pubmed.ncbi.nlm.nih.gov/23393184/}
12. _{Enhanced oxidative stress in Hashimoto's thyroiditis: inter-relationships to biomarkers of thyroid function.Rostami R1, Aghasi MR, Mohammadi A, Nourooz-Zadeh J. Clin Biochem. 2013 Mar}
13. _{Changes in Glucose-Lipid Metabolism, Insulin Resistance, and Inflammatory Factors in Patients With Autoimmune Thyroid Disease Yi Lei et. al. J Clin Lab Anal . 2019https://pubmed.ncbi.nlm.nih.gov/31350776/}
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15. _{Correlation Between Hashimoto's Thyroiditis-Related Thyroid Hormone Levels and 25-Hydroxyvitamin D Guanqun Chao, Yue Zhu, Lizheng Fang. Front Endocrinol (Lausanne). 2020 Feb. https://pubmed.ncbi.nlm.nih.gov/32117049/}
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17. _{Improving the Vitamin D Status of Vitamin D Deficient Adults Is Associated With Improved Mitochondrial Oxidative Function in Skeletal Muscle Akash Sinha et. al. J Clin Endocrinol Metab . 2013. https://pubmed.ncbi.nlm.nih.gov/23393184/}
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