Why Patients with Hashimoto’s Disease Struggle to Loose Weight and Have Low Energy Levels

Weight disturbances and chronic fatigue are the main symptoms accompanying Hashimoto’s thyroiditis and are expected to affect most patients diagnosed with the condition.

It is a particularly challenging disease to manage, but improvement is possible by identifying and correcting the deficiencies and metabolic disorders that underlie it.

Three out of four patients diagnosed with autoimmune thyroiditis experience difficulty regulating their weight and maintaining normal energy levels ^[1][2].

This difficulty arises because Hashimoto’s is fundamentally a disease with a strong metabolic component.

This is because deficiencies and metabolic disorders, which are not easily detected by standard lab tests, can go unnoticed for many years

An increasing number of studies link specific nutritional deficiencies and metabolic disturbances to the onset of the disease and to the symptoms that accompany it.

Hashimoto’s thyroiditis develops due to the combined effect of multiple coexisting imbalances, all of which contribute to difficulty managing body weight and low energy efficiency ^{[3][4][5][6][7]}:

• Insulin resistance
• Immune system dysfunction (autoimmunity, increased susceptibility to infections)
• Vitamin D deficiency
• Lack of essential micronutrients (minerals, vitamins, fatty acids, antioxidants)
• Hormonal deregulation
• Gut microbiome disruption
• Chronic inflammation
• Impaired energy metabolism
• Disordered lipid metabolism

These factors impair thyroid gland function and affect the body’s overall metabolic balance.

Over time, they contribute to the formation of antibodies against the thyroid gland, disrupt energy production, and block normal metabolic processes.

If the deficiencies and metabolic imbalances affecting patients with Hashimoto’s are not identified and corrected, energy levels, body weight, and overall health progressively  gradually and steadily deteriorate..

Encouragingly, identifying these underlying disturbances through specialised testing—and correcting them through targeted precise interventions in lifestyle, correcting nutritional deficiencies, and diet—can significantly improve energy levels and support weight loss, transforming the course of Hashimoto’s thyroiditis.

Early detection and timely intervention are crucial for improving quality of life, restoring body weight to normal, and increasing energy levels.

Hashimoto’s thyroiditis, like all autoimmune diseases, is characterised by chronic inflammation and gradual destruction of the thyroid gland. This chronic inflammation sustains itself through the release of chemical substances (cytokines) in tissues damaged by the immune system’s attack. The whole process sustains inflammation and prevents normal healing ^[8].

In the body’s attempt to adapt and continue functioning in the presence of deficiencies, metabolic disorders, and chronic inflammation, changes occur in normal physiological processes. When these changes are not detected in time, they can lead to alterations that are either permanent or very difficult to reverse ^[9].

This explains why many people with Hashimoto’s disease struggle to manage their weight and restore their energy levels, despite the use of thyroid hormone replacement therapy and significant efforts.

To significantly improve the clinical picture and quality of life in patients with Hashimoto’s disease, personalised care must include not only thyroid hormone regulation provided by the primary care physician, but also the identification and correction of the underlying deficiencies and metabolic disorders that accompany the condition ^{[10][11][12][13][14]}.

The identification and management of these metabolic disorders can only be achieved through advanced lab tests. These tests reveal the factors driving the development and expression of Hashimoto’s thyroiditis.

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

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 care 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 individuals start with their personalised health plan, 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.

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Bibliographic References

_{[1] The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis. Rong-hua Song et al  Front. Immunol., 01 October 2019.}

_{[2] Relationship between thyroid dysfunction and body weight: a not so evident paradigm  Mónica Ríos-Prego et al. Int J Gen Med. 2019.}

_{[3] Gut microbiome and its role in obesity and insulin resistance. Clare J Lee et al. Ann N Y Acad Sci . 2020 Feb.}

_{[4] Metabolic pressure and the breach of immunological self-tolerance Veronica De Rosa, Antonio La Cava & Giuseppe Matarese.18 October 2017. Nature Immunology.}

_{[5] Non-communicable Diseases in the Era of Precision Medicine: An Overview of the Causing Factors and Prospects. Dimitris Tsoukalas et al. Bio#Futures. Springer, Cham. May 2021.}

_{[6] Immunomodulatory Function of Vitamin D and Its Role in Autoimmune Thyroid Disease. Rui Zhao et al. Front. Immunol., 19 February 2021.}

_{[7] Chronic Inflammation in the Context of Everyday Life: Dietary Changes as Mitigating Factors. Margină, D.; Ungurianu, A.; Purdel, C.; Tsoukalas, D. et al Int. J. Environ. Res. Public Health, MDPI (2020). Int. J. Environ. Res. Public Health 2020, 17, 4135.}

_{[8] The end of inflammation? New approach could treat dozens of diseases. National Geographic MARCH 4, 2022}

_{[9] Metabolic features and regulation of the healing cycle—A new model for chronic disease pathogenesis and treatment. Robert K.Naviaux. Mitochondrion 2019.}

_{[10] 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/}

_{[11] Multiple Nutritional Factors and the Risk of Hashimoto's Thyroiditis Shiqian Hu, Margaret P Rayman. Thyroid . 2017 May.}

_{[12] 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.}

_{[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 . 2019}

_{[14] SERUM METABOLOMIC PATTERNS IN PATIENTS WITH AUTOIMMUNE THYROID DISEASE Jia Liu et. al. Endocr Pract . 2020 Jan.‍}

_{[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/}

_{[16] Multiple Nutritional Factors and the Risk of Hashimoto's Thyroiditis Shiqian Hu, Margaret P Rayman. Thyroid . 2017 May. https://pubmed.ncbi.nlm.nih.gov/28290237/}

_{[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/}

_{[18] 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}

_{[19] Thyroid Hormone Effects on Mitochondrial Energetics Mary-Ellen Harper 1, Erin L Seifert.  https://pubmed.ncbi.nlm.nih.gov/18279015/}

_{[20] 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/}

_{[21] Introducing the thyroid gland as another victim of the insulin resistance syndrome. Jorge Rezzonico et al. Thyroid 2008. https://pubmed.ncbi.nlm.nih.gov/18346005/}

_{[22] Metabolic profiling of organic and fatty acids in chronic and autoimmune diseases. Evangelia Sarandi, Dimitris Tsoukalas et al. Advances in Clinical Chemistry. July 15, 2020. Elsevier Inc.}

_{[23] Targeted Metabolomic Analysis of Serum Fatty Acids for the Prediction of Autoimmune Diseases. Dimitris Tsoukalas, Vassileios Fragoulakis, Evangelia Sarandi et. al. Frontiers in Molecular Biosciences, Metabolomics (6), 2019, Published 1 November 2019. https://www.frontiersin.org/articles/10.3389/fmolb.2019.00120/full}

_{[24] Prediction of Autoimmune Diseases by Targeted Metabolomic Assay of Urinary Organic Acids. Dimitris Tsoukalas et. al. Metabolites. 2020 Dec 8.}

_{[25] Environmental Exposures and Autoimmune Diseases: Contribution of Gut Microbiome M. Firoze Khan and Hui Wang. Front. Immunol., 10 January 2020}

_{[26] Non-communicable Diseases in the Era of Precision Medicine: An Overview of the Causing Factors and Prospects. Dimitris Tsoukalas et al. Bio#Futures. Springer, Cham. May 2021.}

_{[27] Metabolic pressure and the breach of immunological self-tolerance Veronica De Rosa, Antonio La Cava & Giuseppe Matarese.18 October 2017.}

_{[28] Nature Immunology.Circulating metabolites in progression to islet autoimmunity and type 1 diabetes. Springer Link. Diabetologia, 2019 Dec.}

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